Health Information Tech /HIT

INTRODUCTION

The Davis Community is a vibrant senior living neighborhood and has been a proud corporate citizen of Wilmington, NC for over 60 years. Established as a skilled nursing facility in the early 1960s, Davis quickly became the premier healthcare center for senior care, and while they have grown and evolved, adding to services offered, we continue to be highly regarded in the region as a community that emphasizes compassion, care, and show of respect and dignity for residents.

COMMUNITY CULTURE

At The Davis Community, deliberate and diligent efforts are made to emphasize and focus on an underlying culture of respect and service that can be seen and felt by all. Employees, residents, and guests of the community are treated with respect and personalized care to the best of the organization’s ability. The desire to continue to elevate all aspects of services is preeminent so that Davis can provide an empowering and caring retirement atmosphere filled with friends, enjoyment, and a fulfilling sense of community.

• State-of-the-art Facilities
• On-demand Pay
• Benefits begin after 30 days
• Low-cost lunches
• Free Membership to our gym and indoor pool
• Shift differential
• Work-life Balance
• Growth
• Competitive Wages

We spend about 2,000 hours per year at work. Why not make that time matter! For us, ‘work that matters’ is less about what you do, and more about how you do it.

The Davis Community requires that all current and new employees, including contract staff, receive an annual influenza vaccination and TB skin test unless a reasonable or disability accommodation is granted.

The Health Information Technician is responsible for maintaining systems for the collection of complete and accurate medical records on each resident/patient/guest and the timely processing, storage, retrieval, security, and release of health information according to organizational policies and procedures and regulatory standards.

MAJOR WORK ACTIVITIES:

1. Assures effective communication with other shifts and disciplines in regards to the medical records.
2. Responsible for processing/coding of all current, resolved and newly documented diagnoses.
3. Responsible for securing signatures on all physician’s phone orders, whether mailed, taken by courier to their office or placed in their mailbox in facility.
4. Management of closed medical records.
5. Maintain routine audit and monitoring systems and focus audits on problem areas, QA concerns, including but not limited to quarterly and closed record chart reviews.
6. Assure physical protection is in place to prevent loss, destruction and unauthorized use of manual records.
7. Manage the release of information functions for the facility including reviewing, processing and required logging of requests for medical records. Maintain facility policies and standards of practice to assure release of information requests are appropriate and meet legal standards.
8. Maintain master forms manual and forms management system for development, review and reproduction of facility forms.
9. Maintain systems for filing, retention and destruction of overflow/thinned records and discharge records, or those stored in electronic format.
10. Maintain a monitoring system to assure telephone orders and other information is signed and completed by the physician as needed. Prepares discharged resident files for offsite storage.
11. Hold monthly Unit Clerk meetings in collaboration with Unit Managers to address issues, update on regulatory/policy changes, and communicate regarding medical record management.
12. Communicates issues/concerns with the Director of Nursing or Administration and reports to Quality & Compliance Administrator.
13. Performs specific work duties and responsibilities as assigned by the Quality & Compliance Administrator.

The Davis Community requires that all current and new employees be fully vaccinated (Covid-19 & Influenza) in order to work unless a reasonable accommodation is approved.

The Davis Community is proud to be an equal-opportunity workplace. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on, age, race, gender, color, religion, national origin, sexual orientation, gender identity, veteran status, disability or any other protected category. The Davis Community is dedicated to providing an accessible environment for all candidates during the application process and for employees during their employment. Please let us know if you need reasonable accommodation to apply for a job or participate in the application process. No question on this application is intended to secure information to be used for such discrimination. Proof of identity and work authorization will be required upon employment in accordance with federal regulations. This Company intends to check and hold you responsible for the accuracy of the statements you make on this application. This application will receive consideration for thirty (30) days. If you have not heard from the Company within thirty days and wish to receive further consideration for employment, it will be necessary to complete another application form.

KNOWLEDGE, SKILLS AND WORKING CONDITIONS:

• Work in well-lighted, well-ventilated setting.
• Low Exposure to infectious diseases.
• Physical exertion required no more than 60% of the time. Intermittent lifting and carrying of objects weighing between 30-40 pounds and pushing of objects weighing at least 100 pounds. Physical exertion also is described as standing, kneeling, and bending.
• May be subject to noisy, hot or cold, humid and busy environment.
• Knowledge of regulations, survey process, accreditation standards and professional standards of practice related to long-term care.
• Must possess strong organizational skills.
• Ability to effectively communicate with all levels of staff.
• Basic word processing computer skills and be able to operate job related office equipment.
• Computer skills and understanding of information systems used in long-term care.
• Communicate via telephone and other automation vehicles.
• Visualize equipment and medical record forms.
• In an emergency, is expected to respond and includes the possibility of evacuation of residents.

MINIMUM QUALIFICATIONS:

Education: Associate Degree or technical training in Health Information preferred. High School Diploma or GED equivalent.

Licensure/Certification: Certification as Health Information Technician preferred.

Experience: At least 2 years of previous work experience in medical records or unit clerk of hospital or long-term care setting.

An equivalent combination of education and experience may be considered.