Essential Functions

The purpose of the essential functions list is to allow prospective students who are considering a career to be informed of the physical, emotional, and psychological demands related to training and employment in a field of study. These lists are provided to allow prospective students to make informed career choices by providing them with a summary of the physical abilities and personality traits that are generally required for the successful completion of a curriculum and result in employment in a field of study after graduation. The tasks below are from the American Health Information Management Association's Registered Health Information Technician (RHIR) domain and represent the program's essential functions:

Domain 1: Data Structure, Content, and Information Governance

Tasks

• Apply health information guidelines (e.g., coding guidelines, CMS, facility or regional best practices, federal and state regulations)
• Apply healthcare standards (e.g., Joint Commission, Meaningful Use)
• Identify and maintain the designated record set
• Maintain the integrity of the health record (e.g., identify and correct issues within the EHR)
• Audit content and completion of the health record (e.g., validate document content)
• Educate clinicians on documentation and content
• Coordinate document control (e.g., create, revise, standardize forms)
• Assess and maintain the integrity of the Master Patient Index (MPI)
• Maintain and understand the data workflow
• Create and maintain functionalities of the HER
• Create and maintain EHR reports to ensure data integrity
• Navigate patient portals and provide education and support

Domain 2: Information Protection: Access, Use, Disclosure, Privacy, and Security

Tasks

• Manage the access, use, and disclosure of PHI using laws, regulations, and guidelines (e.g., release of information, accounting of disclosures)
• Determine right of access to the health record
• Educate internal and external customers (e.g., clinicians, staff, volunteers, students, patients, insurance companies, attorneys) on privacy, access, and disclosure
• Apply record retention guidelines (e.g., retain, archive, or destroy)
• Mitigate privacy and security risk
• Identify and correct identity issues within the EHR (e.g., merges, documentation corrections, registration errors, overlays)

Domain 3: Informatics, Analytics, and Data Use

Tasks

• Identify common internal and external data sources
• Extract data
• Analyze data
• Report patient data (e.g., CDC, CMS, MACs, RACs, insurers)
• Compile healthcare statistics and create reports, graphs, and charts
• Analyze common data metrics used to evaluate Health Information functions (e.g., CMI, coding productivity, CDI query rate, ROI turnaround time)

Domain 4: Revenue Cycle Management

Tasks

• Identify the components of the revenue cycle process
• Demonstrate proper use of clinical indicators to improve the integrity of coded data
• Code medical/health record documentation
• Query clinicians to clarify documentation
• Recall utilization review processes and objectives
• Manage denials (e.g., coding or insurance)
• Conduct coding and documentation audits
• Provide coding and documentation education
• Monitor Discharged Not Final Billed (DNFB)
• Analyze the case mix
• Identify common billing issues for inpatient and outpatient
• Understand payer guidelines and requirements (e.g., LCDs, NCDs, fee schedules, conditions of participation)
• Collaborate with clinical documentation integrity (CDI) staff
• Review and maintain a Charge Description Master (CDM)
• Describe different payment methodologies and different types of health insurance plans (e.g., public vs private)  

Domain 5: Health Law and Compliance

Tasks

• Perform quality assessments
• Monitor Health Information compliance and report noncompliance (e.g., coding, ROI, CDI)
• Maintain standards for Health Information functions (e.g., chart completion, coding accuracy, ROI turnaround time, departmental workflow)
• Monitor regulatory changes for timely and accurate implementation

Domain 6: Organizational Management and Leadership

Tasks

• Provide education regarding Health Information laws and regulations
• Review Health Information processes
• Develop and revise policies and procedures (e.g., compliance, ROI, coding)
• Establish standards for Health Information functions (e.g., chart completion, coding accuracy, ROI, turnaround time, departmental workflow)
• Collaborate with other departments for Health Information interoperability
• Provide Health Information subject matter expertise
• Understand the principles and guidelines of project management