The Cincinnati VA Medical Center is looking for a Lead Medical Record Technician (Health Information Technician). The Medical Record Technician/Lead Review Room is assigned to the Health Information Management Section, Patient Business Services at the Cincinnati VAMC. Occupation involves lead and technical work concerned with processing of medical records. Work requires practical knowledge of human anatomy, physiology, medical terminology, and legal requirements of the medical record.

Duties

The Cincinnati VA Medical Center (CVAMC) is a two-division campus located in Cincinnati, OH and Fort Thomas, KY serving 15 counties in Southwest OH, Northern Kentucky, and Southeast Indiana with 6 Community Based Outpatient Clinics located in Bellevue, KY; Florence, KY; Lawrenceburg, IN; Hamilton, OH; Clermont County, OH, and Georgetown, OH. The CVAMC also supports two off main campus locations in the Cincinnati area via an Eye Center and Mental Health Outreach Community Division. Duties include but are not limited to: The incumbent is responsible for ensuring that all patient care data entered in the Electronic Health Record (EHR) is accurate, timely, and complete, adhering to established documentation requirements as outlined by Joint Commission regulations, Veterans Health Administration (VHA) guidelines, as well as medical-legal requirements. Monitors delinquent list for follow-up purposes on necessary documents (i.e., operation reports, discharge summaries, etc.) that are needed for completion of medical records. Works with the patient treatment teams to identify correct responsible clinicians for documentation. Prepares complex weekly and monthly reports noting the status of all incomplete/delinquent records and compliance reports and submits the reports to the appropriate administrative and clinical staff. Identifies reviews, verifies, and corrects all statistical data concerning medical transcription to maintain accuracy of medical and statistical reports. Compares and resolves discrepancies between daily Gains and Losses Sheet, Digital System Workload Report and contract transcription logs as it relates to timeliness and accuracy of dictated reports completed by medical transcription contractor. Facilitates team or unit processes by working in collaboration with team members or employees to ensure that tasks are completed, that good working relationships among team members and with management are maintained, and that team priorities and goals, needs, and achievements are coordinated with management. Performs lead functions over MRT (HIT) positions. Provides guidance and technical direction necessary for accomplishing the work of the unit or team. Serves as work leader, assuring the work assignments of employees in the unit are carried out. Distributes and balances workload and tasks among employees. Assures the timely accomplishment of work assigned to the team. Assures each team member has an integral role in developing the final product or providing the assigned service. Communicates to the team the problem to be solved or program issues under review and coaches the team and/or individual team members in identifying the parameters of a viable solution. Ensures the organization's "vision" is integrated into the team's goals, strategies, activity plans, and work products. Ensures team members participate in both short-term and long-term planning stages of team projects. Resolves simple informal complaints of employees and refers more serious matters to the supervisor. Makes written instructions, reference materials, and relevant background material available. Obtains needed information on decisions from the supervisor on major issues and problems that arise. Maintains records of work accomplishments. Checks work in progress to see that supervisor's instructions have been met. Instructs employees in specific tasks and job techniques. Trains team members in the accomplishment of tasks or projects. Maintains current knowledge and answers questions from team members on procedures, policies, and directives. Provides expert advice on specific tasks, procedures, and policies. Makes written instructions, reference materials, and relevant background material available. Obtains needed information on decisions from the supervisor on major issues and problems that arise. Resolves simple informal complaints of employees and refers more serious matters to the supervisor. Makes recommendations to supervisor as requested concerning promotions, reassignments, recognition of performance and personnel needs. Work Schedule: 8:00am-4:30pm Telework: As determined by the agency policy or will be discussed during the interview process. Virtual: This is not a virtual position. Functional Statement #: 91849-0 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, and a general understanding of health records. Six months of the required one year of creditable experience must have provided the knowledge, skills, and abilities (KSAs) needed to perform MRT HIT work. OR Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education, with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management (e.g., courses in medical terminology, anatomy, physiology, legal aspects of health care, and introduction to health records). OR Experience/Education Combination: Equivalent combinations of creditable experience and education are qualifying towards meeting basic experience requirements. The following educational/training substitutions are appropriate for combining education and creditable experience: Six months of creditable experience that indicates knowledge of medical terminology, privacy and release of information, the health record, and one year above high school with a minimum of six semester hours of health information technology/health information management. Six months of creditable experience that indicates knowledge of medical terminology, privacy and release of information, the health record, and successful completion of a course for medical technicians, hospital corpsmen, medical service specialists, or hospital training obtained in a training program given by the U.S. Armed Forces or the U.S. Maritime Service, under close medical and professional supervision, may be substituted on a month-for-month basis for up to six months of experience, provided the training program included courses in anatomy, physiology, and health record techniques and procedures. Grandfathering Provision: All persons employed in VHA as a MRT HIT, on the effective date of this qualification standard, are considered to have met all qualification requirements for the grade held, including positive education and licensure/certification/ registration 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 to it, the following provisions apply: Such employees in an occupation that does not require a licensure/certification/ registration, may be reassigned, promoted, or demoted within the occupation, but will not be promoted beyond the journey level or placed in supervisory or managerial positions. Employees 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/certification/registration that meet all the basic requirements of this qualification standard, must maintain the required credentials, as a condition of employment in the occupation. English Language Proficiency: MRTs HIT must be proficient in spoken and written English, as required by 38 U.S.C. § 7403(f). 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). Grade Determinations: Lead Medical Records Technician (HIT) GS-08: Experience: One year of experience equivalent to the next lower grade level. Experience includes but not limited to; review, analyze, abstract, maintain, extract, and compile information from the health record independently with minimal supervision. They analyze health records for accuracy, completeness, timeliness, consistency, and compliance (e.g., scanned, uploaded, use of correct titles, linked to correct encounters, etc.) with HIM industry standards, policies, procedures, laws, regulations, and accreditation requirements. They also coordinate and/or perform health record review activities to satisfy external accreditation requirements and medical center performance measures. They communicate regularly with staff at various levels of the organization regarding delinquent health records and notify individual clinical providers regarding incomplete medical records. MRTs HIT prepare complex reports, calculate department statistics, note the status of all incomplete/delinquent records, and submit reports to the appropriate administrative and clinical staff and committees/leadership to ensure deficiencies are resolved and completed appropriately. They serve as the expert resource for clinical staff and assist clinical providers with completion or correction of their health record documentation. They conduct the review of incomplete records for individuals clearing the facility. Demonstrated Knowledge, Skills, and Abilities: In addition to the experience above, the candidate must demonstrate all of the following KSAs: Comprehensive knowledge of health record technology methods, procedures, and techniques. Ability to work with a team to provide technical guidance, and to plan, organize, and coordinate activities to effectively complete job assignments (i.e., distributing workload, monitoring the status and progress of work, monitoring accuracy of work, and ensuring required timelines are met.) Skill in communicating effectively, both orally and in writing, to meet program objectives. Ability to prepare reports in a variety of formats and present data to individuals at various organizational levels. Ability to coordinate and provide staff development and training. References: VA Handbook 5005/124 PART II APPENDIX G59. MEDICAL RECORDS TECHNICIAN (HEALTH INFORMATION TECHNICIAN) QUALIFICATION STANDARD GS-0675. Physical Requirements: The work with computers is mainly sedentary in an office environment. See VA Directive and Handbook 5019, Employee Occupational Health Service.

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 Cincinnati VA Medical Center 3200 Vine Street Cincinnati, OH 45220 US
• Name: Michelle GradyCagle
• Phone: 513-557-8818
• Email: [email protected]