Job Description

The Health Information Management (HIM) Lead provides day-to-day leadership and oversight of the HIM function, including the maintenance, storage, processing, and release of all medical records and EHR data. This role guides and supports HIM Coordinators and other HIM staff, serves as the subject-matter expert on release-of-information and records-management practices, and ensures departmental operations comply with medical, administrative, ethical, legal, and regulatory requirements of a mental health care system. The HIM Lead is responsible for maintaining a valid Notary Public commission and for obtaining AHIMA Certified in Healthcare Privacy and Security (CHPS) certification within one (1) year of hire, in support of the organization’s privacy and security compliance program.

ABM Culture

At Apogee Behavioral Medicine, we believe exceptional patient care starts with exceptional team members. Our Administrative Coordinators are often the first point of contact for patients and play a critical role in creating a welcoming, professional, and supportive environment. We value individuals who are proactive, adaptable, service-focused, and willing to take ownership of both patient experience and day-to-day office operations. Success in this role requires a positive attitude, strong attention to detail, and a willingness to jump in wherever needed to support patients, providers, and fellow team members.

Responsibilities

Leadership & Supervisory Responsibilities

• Leads, trains, schedules, and mentors HIM Coordinators and support staff; serves as the first point of escalation for complex or non-routine records requests and disputes.
• Assigns and monitors daily workflow across assembly, analysis, release of information, data processing, and reporting to ensure timeliness and accuracy.
• Conducts quality audits of medical record documentation and staff work product; identifies trends and implements corrective action plans.
• Assists the HIM Manager/Director with departmental policy development, staff onboarding, and performance evaluations.
• Acts as backup department lead in the Manager/Director’s absence.

Core Responsibilities

• Provides information to internal and external inquiries to ensure needs are met in accordance with policy and procedure regarding disclosure of information.
• Reviews medical records for content, accuracy, and completeness; verifies client information, forms, and records; resolves complex or escalated errors and completes records processing in accordance with policies and procedures.
• Ensures data is collected accurately and on time, inclusive of clients’ demographic and episodic information.
• Retrieves and researches medical health charts; completes and reviews a variety of forms and documents relating to entries in medical records.
• Maintains and applies working knowledge of a hybrid medical record system, including EHR system administration and troubleshooting.
• Verifies client information; prepares and indexes documents in the EHR system; verifies the accuracy of scanned documents against source documents and ensures documents are legible and properly indexed for accurate retrieval.
• Monitors and tracks compliance with legal documents and correspondence with clients, as well as internal and external stakeholders.
• Serves as the primary liaison with Legal and Risk teams regarding releases of information, subpoenas, and other legal documentation requests.
• Notarizes HIM-related documents, affidavits, and authorizations as required in the course of departmental operations.
• Supports privacy and security compliance initiatives, including risk assessments, breach-response procedures, and staff training on HIPAA, 42 CFR Part 2, and related regulations, in coordination with the Privacy/Compliance Officer.

Qualifications

Skills & Experience

• Bachelor’s degree preferred; High School Diploma or equivalent required.
• 3+ years of experience in Health Information Management, including prior experience in an inpatient or outpatient psychiatric program or acute hospital setting preferred.
• 1+ years in a lead, supervisory, or informal leadership capacity preferred.
• Demonstrated experience with EMR/EHR systems, documentation standards, release-of-information processes, and legal issues pertaining to HIPAA, 42 CFR Part 2, and other health information regulations.
• Working knowledge of privacy and security best practices; AHIMA CHPS or willingness to obtain within required timeframe.
• Active Notary Public commission, or ability to obtain one promptly upon hire.
• Strong written and verbal communication skills, with the ability to train and mentor staff.
• Strong organizational skills with the ability to manage competing priorities, multi-task, and work independently as well as lead a team.

Required Certifications & Credentials

• Notary Public: Must possess, or obtain within an organization-defined introductory period, a valid Notary Public commission for the state of employment, and maintain it in good standing throughout employment.
• CHPS Certification: Must obtain the AHIMA Certified in Healthcare Privacy and Security (CHPS) credential within one (1) year of hire and maintain it in good standing thereafter, including completion of all required continuing education for recertification.

The organization will support exam preparation and testing costs in accordance with company policy. Failure to obtain the CHPS credential within the required timeframe, absent an approved extension, may affect continued eligibility for this role.

Working Conditions

Primarily an office-based role within a mental health care setting, with regular use of computers, scanners, and EHR systems. May require occasional extended hours to meet departmental deadlines or compliance requirements. Required to be at ABM corporate offices Monday-Thursday of each week.

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