HIM SPECIALIST

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Occ Summary

Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records. Activities required include research, analysis, and compilation of findings into summarized reports that will be shared within and external to the Health Information Management Department. Positions at this level have high customer service and strong analytical and problem-solving skills, and require interpretation and explanation of policy and external requirements related to privacy, release of information, positive patient identity, and other department and organization-wide functions. Specific job responsibilities are based on the service unit within Health Information Management assigned. Expert computer skills to navigate and query multiple electronic record systems.

Release of Information: Regular interaction is required with patients, attorneys, governmental agencies, providers of health care, insurance companies, auditing agencies, and researchers. Detailed working knowledge and ability to apply HIPAA rules, North Carolina General Statutes, and other state and federal laws regarding patient privacy.

Work Performed

 Release of Information Functions:

Assess complex third-party requests for medical records to determine the authority of the supporting documentation submitted. Investigate and analyze the request compared to the patient authorization and/or state and federal regulations for permitted disclosures to determine if the identified dates of service, entity, provider, and specific clinical documents requested can be released as requested. Works in the electronic health record and decentralized electronic databases to locate specific clinical documents to fulfill a request. This includes processing the Office of Civil Rights, the Office of the Inspector General, and other governmental counsel to support litigation for and against Duke Health. Other mental agencies, as well as other legal requests for both internal and external complex requests, involve research, concealed gun permits, sexual assault, and child abuse/neglect record releases, which are highly sensitive. These requests require the most extensive release of information, knowledge, working directly with providers, and special access to review documentation not available to all ROI staff.

Analyze patient authorizations, power of attorney documentation, guardianship documentation, and estate documentation to validate HIPAA-required elements and the legal authority of the individual or entity to make requests on behalf of the patient to facilitate the provision of PHI under federal regulation for the Patient and Personal Representative Right of Access.

Evaluate North Carolina out-of-state subpoenas and state and federal court orders to determine the validity of court documentation for authority to demand production and deposition of records and provide verbal and written response to the requestor if deemed invalid.

Appear as a representative of Duke Health Enterprise in the State of North Carolina and the Federal court to produce certified copies or original health records. Appears in scheduled depositions as required.  Acts on behalf of DUHS HIM as the Custodian of Records for Duke University Health System and testifies as to the authenticity of health records containing PHI. 

Facilitates access for health plan auditors and research analysts through the preparation of electronic medical records, EMR access provisioning, assigning of passwords, and deactivation of passwords after visits. Assists DHE personnel in locating specific documents in the EHR as needed and permitted based on statute, regulation, and policy. 

Investigates and facilitates requests for patients to amend PHI based on a right under federal regulation; locates disputed documentation in the electronic health record and informs the treating provider of the patient’s request for amendment. Coordinate with the patient, compliance, legal counsel, risk management, providers, and the clinical team for a timely response to regulations. Maintains the amendment tracking process for appropriate reporting and completion of requests to ensure the patient is notified of the outcome in compliance with the HIPAA-required time frame. 

Coordinates with PRMOSelf Pay to obtain itemized statements and use information to calculate lien balances. Create and generate an attorney lien letter and forward the itemized statement to the requestor as needed to protect Duke Health’s interest in settlements related to personal injury.

Initiates communication with treating providers or overseeing Chief Medical Officers to obtain approval to release psychiatric encounter records when requested by the patient, and seeks to provide approval to release records for minor patients ages 12-17 to parents to comply with additional privacy protections under NC Statute and Federal Law. 

Perform other duties assigned, to include initial investigation of patient and customer service complaint log entries to review for violation of the patient’s right of access or inappropriate response to the authority of the requestor to obtain PHI. 

Knowledge, Skills, and Abilities

Good organizational skills, excellent investigative/analytic skills with detail orientation, and strong follow-through capabilities.

Must have the ability to independently pursue obtaining records outside of the legal medical record to support designated record set requests. 

Extensive knowledge of HIPAA regulations, state laws, and patient rights.

Excellent verbal and written communication skills to effectively problem-solve, develop working relationships and assist system users.

Must be able to meet deadlines, work independently, set priorities, and maintain confidentiality.

Ability to work calmly and efficiently in high-pressure situations.

Intermediate knowledge of human anatomy and physiology and medical terminology is highly preferred.

Intermediate to expert skills using Windows-based software and familiarity with information technology hardware and software in a local and wide area network environment.

Level Characteristics

Minimum Qualifications

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy-related conditions), sexual orientation, or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Education

High School Diploma required; Associate's degree in health information management or a related field preferred

Experience

Four years of experience in a health care-related field are required, two of which must be in health information. Candidates with an Associate's degree in HIM require two years of healthcare experience and one year of HIM-specific experience, or Candidates with a bachelor's degree in HIM require two years of healthcare experience, or candidates with a Bachelor's degree in health care require two years of HIM-specific experience.

Degrees, Licensures, Certifications

preferred: RHIT/RHIA/CHPS/CHDA

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.