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- Discuss how medical coding impacts the health care revenue cycle. 2.1 Outline the roles and responsibilities of health information professionals, including medical
coders. Required Unit Resources Chapter 21: Seeking a Position as an Administrative Medical Assistant (ULO 2.1) Unit Lesson Lesson: Health Information Management - Career Responsibilities and Opportunities (ULO 2.1) Introduction Health information management (HIM) is an evolving field that plays a crucial role to uphold the integrity, security, and proper use of patient data within the healthcare system. Professionals in HIM unite the clinical, operational, and administrative functions in healthcare organizations. With the rise of technology, particularly artificial intelligence (AI), HIM careers are experiencing opportunities for growth and unique challenges. As you progress in this course and become more knowledgeable about health information management, think back to the responsibilities, employment opportunities, and industry trends you have noticed in the health industry. Use this unit as a guide that will guide you to the HIM role that is the best fit for you. Certifications in Health Information Management HIM professionals work in a variety of settings, including hospitals, outpatient clinics, insurance companies, government agencies, and medical technology firms. Having credentials is crucial to being a professional in health information management. Throughout this unit we will discuss roles and their recommended certifications. Two credible accrediting bodies in health information management are the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). These organizations have been valuable resources for healthcare professionals when it comes to advancing health information initiatives and improving the careers of HIM professionals.
- For example, a role such as a revenue cycle specialist, which involves maintaining coding/billing records and ensuring data accuracy requires a certification like the Certified Coding Associate (CCA) from AHIMA.
- Another role that requires a similar type of certification would be a medical coder, who specializes in coding medical procedures for billing and reimbursement purposes.
- Medical coders need knowledge of coding systems and certifications such as Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
- Health data analysts, on the other hand, focus on analyzing patient and operational data to improve healthcare delivery and typically require a bachelor’s degree and proficiency in data analytics tools.
- Compliance officers help organizations adhere to healthcare regulations and standards, requiring expertise in legal compliance and certifications such as Certified in Healthcare Privacy and Security (CHPS) from AHIMA or Certified Professional Compliance Officer (CPCO) from AAPC.
- Health information managers oversee the HIM department, focusing on strategic planning, staff
UNIT II STUDY GUIDE
Health Information Management - Career Responsibilities and Opportunities HTH 2305, Health Information Documentation Management 2 UNIT x STUDY GUIDE Title management, and system implementation. This role typically requires advanced education, such as a bachelor’s or master’s degree, and credentials like a Registered Health Information Administrator (RHIA) from AHIMA.
- If your skill set is more tuned to problem-solving or putting together a puzzle, inpatient coding may pique your interest. AHIMA, which is the other well-renowned HIM credentialing organization, offers certifications like Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), and Certified Health Data Analyst (CHDA).
- For those focusing on ensuring HIPAA regulatory standards, a credential like the Certified in Healthcare Privacy and Security certification can prepare professionals wanting to pursue a career in privacy practices and information security.
To excel in the HIM field, it is essential to develop specific skills and obtain relevant certifications. It is also important to understand classifications of different certifications. AAPC offers three certifications that are widely recognized in HIM: the Certified Professional Coder (CPC), the Certified Inpatient Coder (CIC), and the Certified Outpatient Coder (COC). The CPC is a comprehensive certification that can cover many disciplines, while the other two are a bit more specific to the tasks that they will be performing. Essential skills for HIM professionals include technical proficiency with a variety of technologies including EHR systems, coding software, and data analysis tools. Health care workers must have excellent attention to detail in data entry, coding, and regulation compliance. Strong communication skills are also necessary for collaborating with healthcare teams and explaining complex data insights. Finally, adaptability is vital to keeping up with technological advancements and regulatory changes. Responsibilities of Health Information Management Professionals HIM professionals are responsible for managing and safeguarding patient information. Primary responsibilities include maintaining patient medical records via EHRs, ensuring that clinical documentation and procedural documentation match for medical necessity reasons, or submitting reimbursement claims from third-party payers. In other capacities, health information professionals can utilize medical data to support medical decision-making or ensure compliance with HIPAA laws and other state and federal regulations. HIM professionals also prepare audits and address documentation discrepancies that help organizations avoid legal and/or financial consequences. Medical coding is another significant HIM responsibility. Assigning standardized codes to medical procedures and diagnoses using coding systems like ICD-10, CPT, and HCPCS is important for the healthcare revenue cycle. Medical coders collaborate with medical billing teams to ensure accurate reimbursement from insurance companies and address claim denials by resolving errors in medical coding. Additionally, HIM professionals analyze healthcare data to identify trends that improve patient care and implement strategies for quality improvement initiatives. Current Trends and Changes in the HIM Field HIM professionals must adapt to stay relevant as the health care industry grows and evolves. One major modern trend is the integration of artificial intelligence, which can greatly aid HIM by automating repetitive tasks and enhancing data analysis. AI tools like computer-assisted coding (CAC) can streamline the medical coding process, improve accuracy, and reduce workload. Predictive analytics help predict patient outcomes and identify at-risk populations, supporting proactive healthcare interventions. However, HIM professionals must address ethical challenges surrounding AI as discussed in our last unit, such as biases in algorithms and data privacy concerns. Increasing cyber threats necessitate advanced encryption, firewalls, and multi-factor authentication to secure patient data. Regular staff training on recognizing phishing attempts and other threats should be implemented to counter these threats. Changing regulations also require HIM professionals to stay informed, particularly regarding interoperability standards put forth by legislation like the 21st Century Cures Act and HITECH, which promotes data sharing between healthcare systems. Professionals must do their due diligence to stay informed and adhere to state and federal privacy laws. The Department of Health and Human Services website, specifically the Centers for Medicare and Medicaid Services sections can help provide policy changes and updates related to health information regulations. HTH 2305, Health Information Documentation Management 3 UNIT x STUDY GUIDE Title AHIMA, AAPC, and Healthit.gov are other credible resources for providing information on evolving HIM standards. There is also an increased demand for HIM professionals due to the growing need for healthcare services. The U.S. Bureau of Labor Statistics projects a 16% growth in health information technologist and medical registrar roles from 2023 to 2033. The expansion of telemedicine has also created new opportunities for HIM roles. The healthcare industry’s shift towards patient-centered models emphasizes transparency and engagement, requiring HIM professionals to facilitate secure access to health records and educate patients about their health information and rights. Preparing for a Career in HIM While there are many technical aspects of preparing yourself for a career in HIM, there are some clerical items that you should have prepared. As with any job, you will need to structure your resume so healthcare organizations can see that you are the best fit for the job. The course textbook does an amazing job outlining the interview process, including how to locate employment opportunities and prepare application materials. Throughout this unit's lecture, we have discussed certifications and how they will help you in your HIM career journey. Certifications, however, will not guarantee a job, and sometimes this can be frustrating. Most employers want to hire medical coders with experience which can leave someone with a freshly earned medical coding certification and no experience on the outside looking in. Thankfully, there are internship programs that can provide newly certified individuals with medical coding experience. This can be a great way to get your foot in the door and apply knowledge in real-life scenarios. If you find yourself running into obstacles during your job hunt, try to search for jobs based on responsibilities rather than job titles. Applying for jobs that coincide with your skillset gives you an advantage in discussing why you are the right person for the job. For example, if you are well-versed in managing patient information, you can discuss ways in which you have upheld information privacy and security standards and how that knowledge has made you a more well-rounded healthcare professional. Conclusion Health information management offers many career opportunities for those interested in technology and data management and how it impacts the healthcare industry. With the integration of AI, evolving regulations, and an increased demand for healthcare services, HIM professionals are more critical than ever. Aspiring professionals must focus on education, certifications, and staying informed on industry trends to build successful careers. When HIM professionals adequately prepare themselves, they can make informed decisions about their career path. References AAPC. (2025). Transforming careers: AAPC Certified Professionals in the AI era. https://www.aapc.com/resources/transforming-careers-aapc-certified-professionals-in-the-ai-era French, L. L., & Turner, L. H. (2024). Administrative medical assisting (9th ed.). Cengage. U.S. Bureau of Labor Statistics. (2024, December 26). Occupational Outlook Handbook, Health Information Technologists and Medical Registrars. https://www.bls.gov/ooh/healthcare/health-information- technologists-and-medical-registrars.htm U.S. Food & Drug Administration (FDA). (2020, January 31). 21st Century Cures Act. https://www.fda.gov/regulatory-information/selected-amendments-fdc-act/21st-century-cures-act HTH 2305, Health Information Documentation Management 4 UNIT x STUDY GUIDE Title Learning Activities (Nongraded) Nongraded learning activities are provided to aid you in your course of study. You do not have to submit them. If you have questions, contact your instructor for further guidance and information. Complete the following: