Under the general direction and supervision of the Health Information Director/Designee, the Compliance/Health Information Specialist is responsible for auditing compliance with all regulations (clinical and non-clinical) pertaining to PACE CNY and the Diagnostic and Treatment Center (D&TC).  In addition, the Specialist will assist the Director in other departmental duties related to reporting, maintenance of electronic medical record (EMR) functions, auditing of health information related activities, and other departmental activities.

Job Duties Specific to This Position:

• Audits EMR documentation and data for accuracy, integrity, and compliance. Ensures information collected is complete, accurate and in compliance with applicable federal and state regulatory requirements. 
• Prepares for audits from DOH and CMS on a continual basis. Monitors all requirements and audits for compliance.  Shares this information with the Health Information Director and assists in corrective action planning
• Audits internal processes, EMR documentation and other data to ensure compliance with applicable state and federal regulatory requirements, including identifying, investigating, and reporting compliance issues, irregularities, and violations to the Health Information Director.
• Assists in the implementation and maintenance of the PACE CNY compliance program, including review of the program and relevant staff training as requested by the Health Information Director.
• Conducts functional and process audits as directed by the Health Information Director; identifies deficiencies and potential corrective actions and advises management of same.
• Compiles monthly census and program reports and distributes accordingly.
• Ensures medical information is shared with, and received from, skilled nursing facilities, adult housing and other entities as required by state and federal regulations.
• Completes routine health information disclosures to participants, family members and other caregivers, ensuring compliance with all state and federal regulations.
• Assists with ongoing training to all employees related to privacy, monitoring of program and staff for potential breaches of confidentiality, advises Health Information Director of concerns and assists with corrective action planning.
• Performs departmental quality assurance functions required for compliance with regulatory agencies/laws as well as the program’s quality standards. Audits EMR related record maintenance and the releasing of health information, ancillary QA, discharge summaries and Part A Days plus follow up of specialists’ reports, etc. Summarizes findings; assists Health Information Director in developing, implementing, and monitoring plans of correction as appropriate.

Job Expectations for All Employees:

• Promotes and role-models the mission, values, vision and strategic goals of Loretto in all interactions with staff, peers, residents, family members, vendors and visitors. Treats people with dignity, professionalism and kindness.
• Demonstrates excellent internal and external customer service skills such as friendly greeting, making eye contact, listening attentively, responding in a timely manner, showing respect and empathy and acting as a role model for staff and peers.
• Demonstrates excellent work attendance, reliability and work ethics.
• Attends and actively participates in required meetings and training sessions.
• Complies with established policies, procedures, and codes of conduct at all times.
• Adheres to all health and safety requirements, regulations, policies and procedures.
• Practices and teaches safety awareness. Identifies and reports or corrects any possible safety or environmental issues.
• Understands all HIPAA and other compliance & regulatory requirements associated with their role, including completion of required internal or external training/certifications.
• Performs a variety of related duties as assigned.

• Associates Degree in Health Information Management or other related healthcare field.
• Registered Health Information Technician (RHIT) or Certification in Healthcare Compliance (CHC) required.
• At least 3 years of experience in the field of health information management required. A combination of outpatient and inpatient settings preferred.  Experience in health care compliance strongly suggested.
• Ability to work with all disciplines/areas of the healthcare field.
• Proficiency with MS Office and able to learn new software rapidly. Prior experience with EMR systems required.
• Knowledge and experience in managed care environment highly desirable.
• Attention to detail and accurate input skills required.
• Strong organizational and analytical skills with ability to prioritize work.
• Strong written and verbal communication skills; strong analytical, organizational and time management skills required.

An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.

Physical Requirements

Walking/Standing        15.00% 

Sitting                          80.00%

Lifting                            5.0%

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Loretto reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

• Pay Range $19.79 - $21.10 / hour
• Excellent medical, dental, prescription and vision insurance
• Disability coverage
• Tuition Reimbursement Program
• 401(k) Retirement/Pension Plans
• Discounted Gym Membership
• Paid Time-Off Accrual
• Fun events for employees
• Convenient locations with free parking
• Employee Coaches - to help you achieve life goals
• Diaper Assistance Program
• Opportunity for career growth and movement within 19 sites