Medical Records Administration Specialist (MRAS) in VHA perform work concerned with the management of a health record program or the provision of services related to medical record administration/health information services. MRASs manage, preserve, analyze, and supervise the use of diagnostic and therapeutic health records/health information management. They develop policies and procedures and provide advice on the use of health records and health information management.

Duties

The major duties and responsibilities of the position for Medical Records Administration Specialist: Assists the Chief, Health Information Management (CHIM) and the HIM Department in identifying and setting short- and long-range goals, program objectives and tasks to meet the mission and vision of the VAMC. Provides subject matter expertise to Service Line Leaders, and medical center staff. Interprets and applies The Joint Commission (TJC) standards, VA regulations and medico-legal requirements; current Federal Codes pertinent to health records; Veterans Administration policy memoranda, directives and handbooks pertinent to health information management; medical coding (ICD, CPT, HCPCS) and reimbursement methodologies; medical and procedural terminology; anatomy and physiology, regulations governing confidentiality of health records; release of information laws and statutes; and all policies/procedures pertaining to VHA health records. Provides training for HIM, clinical and administrative staff on HIM topics. Designs and performs quality improvement projects regarding HIM issues. Assists the CHIM in preparing and conducting various presentations. Keeps current on emerging issues and trends in the health information management field, including process improvement initiatives for HIM, the electronic health record, coding and computer assisted coding, the revenue cycle, release of information and privacy issues, records management, transcription and data entry, and health information exchange. Keeps HIM and clinical staff abreast of changing technology in electronic systems used to collect, process, code, protect and store health information. Performs audits and analyses, preparing and presenting findings and recommendations to the CHIM, Service Line Leaders and medical staff. Reviews, analyzes and reports HIM performance monitors. Advises Principal Investigators and other clinical staff relating to methodologies of retrieving health care data for specific studies. Performs data retrieval for special studies as needed. Participates in various VAMC, VISN and national committees requiring health information management subject matter expertise. May review and test HIM related VistA software patches; test and trouble-shooting VistA menu options and functional issues when HIM users report application errors; perform equipment needs analysis for new or replacement equipment and/or equipment repair; submit work orders or Remedy tickets for correction to HIM software errors. Is the facility expert for software and computer applications related to HIM to provide technical assistance to HIM staff (e.g., coding, ROI, dictation, and speech recognition software). Serves as the point of contact for health record corrections. Documentation corrections may consist of retracting erroneous notes, re-titling notes, assigning notes to or removing from consult requests. Problem solves improperly identified documents with clinicians, Clinical Applications Coordinators (CACs) and others who report problems. Reassigns, rescinds and removes documents when they have been entered or uploaded incorrectly. Establishes criteria and provides education when dealing directly with physicians, nurses and other clinical providers requesting them to complete or adjust pertinent parts of the health records, which are found to be inconsistent or incomplete upon analysis. Assists and provides guidance to supporting clinical services to capture required medical information on patients for computer database input. Selects, compiles and trends medical, surgical and statistical data from numerous components of the health record. Retrieves diagnostic and statistical data for various reports required locally or by VISN or VHA Central Office. May assign User Classes to users at the request of the Chief HIM; responds to questions or issues related to that user class. Reviews requests for new templates or additions/correction to existing templates. Reviews requests for paper forms, creating electronic versions of these forms so that they are always available to users by computer. Work Schedule: Monday-Friday 8:00AM-4:30PM Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 436-52977-0 Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: [Candidates must be a citizen] of the United States. Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency: MRAs must be proficient in spoken and written English. See 38 U.S.C. § 7403(f). Education or Experience: Experience. Three years of [creditable] experience in the field of medical records that included the preparation, maintenance, and management of [health] records and health information systems [demonstrating a knowledge of medical terminology,] medical records [procedures, medical coding, or medical, administrative, and legal requirements of health care delivery] systems. OR, Education. [Successful completion of a bachelor's degree or higher from an accredited college or university [recognized by the U.S. Department of Education, with a major field of study in health information management, or a related degree with a minimum of 24 semester hours in health information management or health information technology.] OR, Experience/Education Combination. Equivalent combinations of [creditable] experience and education that equals 100 percent may be used to meet basic requirements. [For example, two years above high school from an accredited college or university, with 12 semester hours in health information technology/health information management, plus one year and six months of creditable experience that included the preparation, maintenance, and management of health records and health information systems meets an equivalent combination. Certification: Persons hired or reassigned to MRA positions in the GS-0669 series in VHA must meet one of the following: Coding Certification through AHIMA or AAPC. NOTE. See paragraph 2a above for a detailed definition of Coding Certification. HIM Certification through AHIMA. NOTE. See paragraph 2d above for a detailed definition of HIM Certification. Health Data Analyst Certification through AHIMA. NOTE. See paragraph 2c above for a detailed definition of Health Data Analyst Certification. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grandfathering Provision: All persons employed in VHA [as an MRA] are considered to have met all qualification requirements for the title, series, and grade held, including positive education, and [registration and/or] certification that are part of the basic requirements of the occupation. For employees who do not meet all the basic requirements in this standard, but who met the qualifications applicable to the position at the time they were appointed , the following provisions apply: Such employees may be reassigned, promoted up to, and including, the full performance (journeyman) level, or changed to lower grade within the occupation, but may not be promoted beyond the [journeyman] level or placed in supervisory or managerial positions. Employees who were appointed on a temporary basis, prior to the effective date of the qualification standard, may not have their temporary appointment extended or be reappointed on a temporary or permanent basis until they fully meet the basic requirements of the standard. Employees initially grandfathered into this occupation who subsequently obtain additional education and/or licensure/registration/certification, and meet all the basic requirements of this qualification standard, must maintain the required credentials as a condition of employment in the occupation. MRAs who are converted to title 38 [hybrid status] under this provision and subsequently leave the occupation lose protected status and must meet the full VA qualification standard requirements in effect at the time of reentry, as a medical records administrator. Grade Determinations: GS-11 Experience: One year of creditable experience equivalent to the next lower grade level that demonstrates all of the KSAs described at that level. OR, Education: Education equivalent to three full years of progressively higher-level graduate education or a Ph.D., or equivalent doctoral degree from an accredited university or college in the field of health information management. AND Demonstrated Knowledges, Skills, and Abilities: Skill in performance and process improvement techniques to develop and implement new or improved solutions in health information management. Ability to advise management and staff, at various levels, regarding health record documentation requirements and health information management practices based on current industry standards, policies, statues, laws, and regulations. Ability to plan, justify, develop, evaluate, assess, monitor, and advise on current health information management processes and recommend changes in policies or procedures. Ability to determine and evaluate compliance with legal, ethical, and regulatory guidelines and accrediting bodies, as they apply to health information management. Ability to acquire, manage, analyze, interpret, and transform data into accurate, consistent, and meaningful information. Assignments: This is considered the full performance level for MRA positions (MRA/HIM Specialist). MRAs work independently in day-to-day assignments. They perform data mining; complex data analysis; and interpret and transform data into accurate, consistent, and timely information in support of the business and operational needs of the HIM department and the organization. They present findings and recommendations to the Chief of HIM (CHIM) and facility leadership. MRAs perform workflow analyses, recommend process improvements, identify and implement best practices, and implement changes as needed to improve the productivity and quality controls of the HIM department. They prepare workload and production reports, monitor trends to identify efficiencies and outliers, and recommend appropriate actions which may involve collaborating with staff at all levels for resolution. The MRA designs and performs quality improvement projects related to health information management to identify and recommend ways of eliminating, combining, simplifying or improving procedures and processes. They compile diagnostic, procedural, and statistical data, and present reports locally, regionally, or nationally. MRAs lead various health record review activities. They participate in various facility, regional, and/or national committees requiring health information management subject matter expertise. The MRA exhibits broad organizational knowledge, communicates and provides training and education to individuals and groups, at multiple levels, both internal and external to the facility. References: VA Handbook 5005, Part II, Appendix G33. The full performance level of this vacancy is 11. The actual grade at which an applicant may be selected for this vacancy is 11. Physical Requirements: See VA Directive and Handbook 5019.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Fort Harrison VA Medical Center 3687 Veterans Drive Fort Harrison, MT 59636 US
• Name: Vanessa Espinoza
• Phone: 720-723-3562
• Email: [email protected]