Part 1: Using the 15 data users listed in Chapter 4, use the Excel template provided to create a matrix. The rows are your data users. As your column headings, you will enter the reason why the users
PLANNING YOUR CAREER IN HEALTH INFORMATION PLANNING YOUR CAREER IN HEALTH INFORMATION WHAT IS A CAREER IN HEALTH INFORMATION? People who work in this field manage the flow of data produced in the course of providing health care. They collect it, check it, organize, analyze and present it. They also protect information privacy and security.There are jobs at all levels:
• Entry-level administrative jobs in health care can lead to jobs in health information management. These jobs require a high school diploma or equivalent. People in these jobs must have basic computer skills, know about health insurance and understand medical terminology.
• Mid-level jobs require a health information certification such as Certified Coding Associate (CCA), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS). Some require an Associate Degree.
• Mid-to-high level jobs require an Associate Degree or a Bachelor’s degree and two or more years of related experience. Employers strongly prefer certification such as Registered Health Information Associate (RHIA) or Technician (RHIT).
• High-level jobs require a Bachelor’s degree or higher, and a number of years of experience in the field. Also, most employers prefer a certification, such as the RHIA or RHIT.
To move up from one level to the next, you need certifications, work experience and more education . WHERE DO PEOPLE IN HEALTH INFORMATION WORK?
Entry-level administrative jobs are in just about every health care setting as well as in non-health care settings like insurance companies and government offices.
Most of mid-level and higher jobs are in hospitals. People can get their “foot in the door” in a hospital or large health care organization and then take advantage of opportunities for promotion from within.
HOW DOES THE FUTURE LOOK FOR HEALTH INFORMATION CAREERS?
In New York City, there are about 3,000 people working in entry-level health administrative jobs, with more than 100 openings each year. There are almost 4,000 people working in mid- and mid-to-high level jobs, with 160 openings each year. Every year there are more jobs advertised than in the year before. The field is constantly changing, as technology advances. The health information field is expected to grow in the next several years, as demand for health services increases.
HOW CAN I PREPARE TO WORK IN THE HEALTH INFORMATION FIELD?
If you are interested in this field, you should take classes to learn about it. The grid on the back of this brochure shows where you can find these classes in New York City.
It shows CUNY colleges, SUNY colleges and community organizations that offer education and training for people who want to work in the health information field. WHO ENJOYS WORKING IN THE HEALTH INFORMATION FIELD? A career in health information is good for people who:
• Want to work in health care, but not hands-on with patients.
• Are organized, very detail-oriented and like data. • Are good at analyzing information and using logic. • Like working with other people as part of a team.
• Can communicate with patients, co-workers, doctors, nurses and administrators on the job.
• Enjoy working with computers.
• Like learning, since the field is always changing. JOBS IN HEALTH INFORMATION ENTRY-LEVEL JOBS MEDICAL SECRETARY, also called patient services representative or medical administrative assistant. People in these jobs work directly with patients in a doctor’s office or clinic. They gather health information and enter it into an Electronic Health Record (EHR) system.
PATIENT REGISTRAR, also called unit service associate or admitting assistant . These people work with patients in a hospital or nursing home. They gather health information for admitting patients and also make sure information gets to the Medical Records department when patients are discharged. They also help with other clerical duties.
HEALTH INFORMATION MANAGEMENT (HIM) CLERK , also called HIM Assistant , HIM Specialist and HIM Analyst . These jobs are usually in the HIM department of a hospital. People in these jobs make sure medical records are complete and accurate.
MEDICAL BILLER, also called Accounts Receivable Clerk . These jobs could be in any type of health care facility.
These people prepare health insurance claims or bills and do simple coding.
MID-LEVEL JOBS OUTPATIENT CODER. These jobs are in clinics, Emergency Departments or doctors’ offices. They usually require the CCA or CPC credential. People in these jobs are usually involved with billing.
HIM DOCUMENTATION TECHNICIAN, also called Health Records Analyst or Medical Records Technician . These people review patient records in hospitals and make sure they are complete and accurate. Employers prefer the RHIT certification.
CANCER REGISTRAR, also called Tumor Registrar . These jobs require the CTR certification, which involves both an Associate degree and experience.
INPATIENT CODER . These jobs are in hospitals. They are the most complicated coding jobs and usually require the CCS credential. There are more coding jobs in hospitals than in other types of health care facilities. MID-TO-HIGH LEVEL JOBS HIM SUPERVISOR. People in these jobs supervise HIM Clerks. They carry out the operations of the HIM Department in a hospital or large health care facility. They might report to the HIM Manager.
HIM MANAGER in a nursing home or clinic. These people manage the day-to-day operations of the Medical Records department, including supervising the staff. They are responsible for all privacy matters for the organization.
CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST . These people improve the quality and completeness of health information. They work with doctors, nurses and coders to make sure that the medical record accurately includes information about services provided. These jobs usually require at least 3-5 years of experience in a hospital.
DIAGNOSTIC RELATED GROUP (DRG) COORDINATOR, also called DRG Reviewer or Coding Validator . People in these jobs review the work of coders. They may be involved in audits. The job requires a CCS credential and at least five years of coding experience in a hospital. This is the most- advertised job in Health Information Management in New York City.
HIGH LEVEL JOBS EHR IMPLEMENTATION SPECIALIST. People in these jobs make sure staff are trained to use EHR systems. They help to organize the flow of work using an EHR system.
DIRECTOR, HEALTH INFORMATION MANAGEMENT (hospital or large health system). People in these jobs oversee the activities of the HIM department of a hospital.
They organize the work and manage the staff. They work with all of the departments in a hospital and make sure government regulations are followed.
HEALTH INFORMATICS ANALYST OR SPECIALIST. People in these jobs analyze EHR data to help improve the quality of patient care. GATHERING: When people visit doctors, clinics or hospitals, they give health information about themselves. This may be on paper forms, verbally or through computer applications. This information is gathered and is usually entered into an Electronic Health Record (EHR) and/or billing system.
RECORDING: When a doctor, nurse, home health aide or other health practitioner provides a service such as a physical exam or an x-ray, he or she records information about that service in the EHR. Information is kept about what services were provided, who provided them and where. ASSURING DATA QUALITY: This is the heart of the health information management field.
After services are provided, health information professionals make sure the information is complete and accurate. It is very important to collect, update and enter information about patients because this is used to track patients over time and link records from different sources.
BILLING (REVENUE MANAGEMENT): After a person has received health care services, a bill is given to whoever is paying for the service – usually a health insurance company, Medicare or Medicaid, but sometimes the patients themselves. This is part of revenue management. ANALYZING DATA: Health care organizations and public health officials analyze health information. They look at how people use health care services, how effective the care is, and how much it costs, among other things. Analysis is needed to make sure the health care system delivers high quality care.
Security and compliance are also important functions in health information. Health information professionals must be careful to protect patient records. Records must only be released in compliance with laws and regulations. THE FLOW OF HEALTH INFORMATION ANALYZING BILLING ASSURING DATA QUALITY RECORDING GATHERING PATIENT REGISTRAR MEDICAL SECRETARY ANALYST / SPECIALIST HEALTH INFORMATICS HIM DIRECTOR MEDICAL BILLER OUTPATIENT CODER INPATIENT CODER DRG COORDINATOR HEALTH INFORMATION MANAGEMENT CLERK HIM DOCUMENTATION TECHNICIAN CANCER REGISTRAR (A.K.A. TUMOR REGISTRAR) HIM SUPERVISOR OR SPECIALIST HIM MANAGER CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST EHR IMPLEMENTATION SPECIALIST FLOW OF HEALTH INFORMATION ANALYZING BILLING ASSURING DATA QUALITY RECORDING GATHERING PATIENT REGISTRAR MEDICAL SECRETARY ANALYST / SPECIALIST HEALTH INFORMATICS HIM DIRECTOR MEDICAL BILLER OUTPATIENT CODER INPATIENT CODER DRG COORDINATOR HEALTH INFORMATION MANAGEMENT CLERK HIM DOCUMENTATION TECHNICIAN CANCER REGISTRAR (A.K.A. TUMOR REGISTRAR) HIM SUPERVISOR OR SPECIALIST HIM MANAGER CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST EHR IMPLEMENTATION SPECIALIST FLOW OF HEALTH INFORMATION MINIMUM EDUCATION JOB TITLE ENTRY MID MID-HIGH HIGH CERTIFICATION YEARS OF EXPERIENCE ESTIMATED SALARY RANGE* MEDICAL SECRETARY PATIENT REGISTRAR HEALTH INFORMATION MANAGEMENT (HIM) CLERK MEDICAL BILLER OUTPATIENT CODER HIM DOCUMENTATION TECHNICIAN CANCER REGISTRAR INPATIENT CODER HIM SUPERVISOR HIM MANAGER CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST DRG COORDINATOR EHR IMPLEMENTATION SPECIALIST HEALTH INFORMATICS ANALYST OR SPECIALIST HIM DIRECTOR HIGH SCHOOL + TRAINING HIGH SCHOOL + TRAINING HIGH SCHOOL + TRAINING HIGH SCHOOL + TRAINING HIGH SCHOOL ASSOCIATE ASSOCIATE HIGH SCHOOL ASSOCIATE ASSOC. IN RELATED FIELD BACHELOR’S BACHELOR’S BACHELOR’S BACHELOR’S/MASTER’S BACHELOR’S/MASTER’S NONE NONE NONE NONE CCA OR CPC RHIT PREFERRED CTR REQUIRED CCS REQUIRED RHIT PREFERRED RHIT PREFERRED CCS, CDIP SOMETIMES RN CCS RHIA PREFERRED RN OR RHIA RHIA REQUIRED 0-1 0-1 0-1 0-1 1-2 1-2 2-3 2-3 2-3 3-5 3-5 5 - 10 3-5 5 - 10 7-10 $25K - $48K $20K - $40K $25K - $60K $25K - $50K $25K - $48K $23K - $58K $35K - $60K $31K - $59K $31K - $60K $40K - $79K $54K - $98K $46K - $90K $57K -$110K $66K - $120K $58K - $180K THIS CHART SHOWS THE COMBINATION OF EDUCATION, CERTIFICATION AND EXPERIENCE TYPICALLY NEEDED TO QUALIFY FOR EACH POSITION. MEDICAL CODING • AHIMA’s Certified Coding Associate (CCA) and AAPC’s Certified Professional Coder (CPC) are entry-level certifications and are helpful in getting a job in a doctor’s office, clinic or hospital Emergency Department.
• AHIMA’s Certified Coding Specialist (CCS) is a more demanding certification that is needed to be an inpatient coder in a hospital. This is considered the “gold standard” coding credential . HEALTH INFORMATION MANAGEMENT • AHIMA’s Registered Health Information Technician (RHIT) is required for most mid- to high-level jobs. It requires an Associate degree from a CAHIIM-accredited program and passing the RHIT exam. • AHIMA’s Registered Health Information Administrator (RHIA) is required for most high-level jobs. It requires a Bachelor’s degree from a CAHIIM-accredited program and passing the RHIA exam. The CERTIFIED TUMOR REGISTRAR credential is awarded by the National Cancer Registrars Association. It requires an Associate Degree. The amount of experience needed depends on the Associate Degree major. HEALTH INFORMATION CERTIFICATIONS * Estimated salary ranges were supplied by Payscale.com and represent the bottom 10% to the top 10% of salaries in NYC for each position. There are many possible career paths in the health information field. People who start off in entry-level administrative jobs in health care may move into a career in Health Information Management (HIM). There are three main types of career paths in HIM : • CAREERS IN CODING , especially in hospitals. As people gain expertise, they can become very valuable. This is because coding must be correct so that health care providers collect the right amount of money for the services they have provided. • CAREERS IN OPERATIONS , or managing medical records, including EHR systems. These jobs do not involve coding, but require knowledge of how health data is maintained and used.
• CAREERS OUTSIDE OF THE HIM DEPARTMENT or outside a health care provider. These may include jobs in an Electronic Health Records (EHR) company, in care management, compliance or data analytics, or in a hospital’s IT department. MEDICAL CODING REVENUE CYCLE CAREER PATH + Associate +RHIT + 3 years MEDICAL SECRETARY HIM DOCUMENTATION TECHNICIAN HIM MANAGER {in a clinic or nursinghome} + Associate and CTR + 2 years + Bachelor’s degree + RHIA + 3 years + Master’s preferred + 2 years + RHIA preferred HEALTH INFORMATION CLERK CANCER REGISTRAR PATIENT REGISTRAR HIM SUPERVISOR HIM MANAGER DIRECTOR OF HIM + CCS + 5 years + Bachelor’s preferred MEDICAL BILLER INPATIENT CODER DRG COORDINATOR NON-CODING HEALTH INFORMATION MANAGEMENT CAREER PATH + Associate +RHIT + 3 years MEDICAL SECRETARY HIM DOCUMENTATION TECHNICIAN HIM MANAGER {in a clinic or nursinghome} + Associate and CTR + 2 years + Bachelor’s degree + RHIA + 3 years + Master’s preferred + 2 years + RHIA preferred HEALTH INFORMATION CLERK CANCER REGISTRAR PATIENT REGISTRAR HIM SUPERVISOR HIM MANAGER DIRECTOR OF HIM + CCS + 5 years + Bachelor’s preferred MEDICAL BILLER INPATIENT CODER DRG COORDINATOR OUTPATIENT/ LONG-TERM CARE CAREER PATH + Associate +RHIT + 3 years MEDICAL SECRETARY HIM DOCUMENTATION TECHNICIAN HIM MANAGER {in a clinic or nursinghome} + Associate and CTR + 2 years + Bachelor’s degree + RHIA + 3 years + Master’s preferred + 2 years + RHIA preferred HEALTH INFORMATION CLERK CANCER REGISTRAR PATIENT REGISTRAR HIM SUPERVISOR HIM MANAGER DIRECTOR OF HIM + CCS + 5 years + Bachelor’s preferred MEDICAL BILLER INPATIENT CODER DRG COORDINATOR CAREER PATHS Average Annual Openings WHERE THERE ARE COMPUTERS, THERE ARE IT JOBS! SOFTWARE JOBS • HELP DESK/ DESKTOP SUPPORT Provide help and advice to people and organizations using computer software or equipment. TYPICAL ED LEVEL : Some college • APPLICATIONS SOFTWARE DEVELOPERS Develop the applications that allow people to do specific tasks on a computer or other device. TYPICAL ED LEVEL : Bachelor’s degree • NETWORK AND COMPUTER SYSTEMS ADMINISTRATORS These professionals are responsible for the day-to-day operation of computer networks, which are critical components of almost every organization. TYPICAL ED LEVEL : Bachelor’s degree • WEB DEVELOPERS Primarily design and create websites, including patient portals, and some may also develop content for the website and/or monitor the website’s performance. TYPICAL ED LEVEL : Associate degree • SYSTEMS SOFTWARE DEVELOPERS Develop the underlying systems that run the devices or control networks. TYPICAL ED LEVEL : Bachelor’s degree • DATABASE DEVELOPERS/ ADMINISTRATOR (DBA s) Use specialized software to store and organize data and ensure such data are available to users and are secure from unauthorized access. TYPICAL ED LEVEL : Bachelor’s degree plus 1-5 years’ experience CYBER-SECURITY • INFORMATION SECURITY ANALYSTS Carry out security measures to protect computer networks and systems. TYPICAL ED LEVEL : Bachelor’s degree with 1-5 years of experience $120,000 $37,580 $ 5 7, 2 1 0 $60,180 $87,810 $107,690 310 600 $71,410 $100,000 $160,000 $180,000 $120,000 $160,000 $190,000 $140,000 $160,000 $120,000 $130,000 HELP DESK / DESKTOP SUPPORT INFORMATION SECURITY ANALYSTS ANNUAL SALARIES FOR HARDWARE JOBS (2013) AVERAGE ANNUAL OPENINGS Experienced Mid Level Enrty Level AVERAGE ANNUAL OPENINGS AVERAGE ANNUAL OPENINGS: 90 NETWORK & COMPUTER SYSTEMS ADMINISTRATORS NETWORK & COMPUTER SYSTEMS ADMINISTRATORS APPLICATIONS SOFTWARE DEVELOPERS WEB DEVELOPER SYSTEMS SOFTWARE DEVELOPERS DATABASE DEVELOPER/ ADMINISTRATOR (DBA) HELP DESK / DESKTOP SUPPORT In addition to jobs and careers in health information management, some IT professionals work in health care. There are three broad categories of jobs in HEALTH IT: hardware, software and cyber-security. HARDWARE refers to the physical components of a computer. This includes computer networking. Many people enter this field in Help Desk or Desktop Support jobs. Most employers require a certification in network administration such as CompTIA A+ or Network+. Because people in these jobs help computer users to solve computer- related problems, customer service skills are also important. SOFTWARE includes operating systems, applications and programs. Jobs in this category include web developers, applications and system software developers, and database developers. This is a large and growing category of jobs. People in this field usually know more than one programming language. CYBER-SECURITY professionals protect computer networks and the information within them. Because these activities straddle both software and hardware, people in these jobs must know both. The graphics to the right indicate typical education levels for these jobs, but a lot of Health IT is about showing that you know how to do the job and have experience. People learn on the job and move to higher positions based on their experience and track record. Industry certifications can be important. HARDWARE JOBS $79,200 $119,690 $147,560 ANNUAL SALARIES FOR CYBER SECURITY (2013) Experienced Mid Level Enrty Level + + ++ ++ ++ +++ +++ + Growing faster than average for all jobs ++ Growing twice as fast as average +++ Growing three times as fast as average SOURCE: New York State Department of Labor. Estimates for average annual openings span occupational employment across all industries in NYC. database systems web develop software developer $160,000 $120,000 $190,000 $160,000 $130,000 APPLICATIONS SOFTWARE DEVELOPERS WEB DEVELOPER SYSTEMS SOFTWARE DEVELOPERS DATABASE DEVELOPER/ ADMINISTRATOR (DBA) ANNUAL SALARIES FOR HARDWARE JOBS (2013) Experienced Mid Level Enrty Level $73,790 $50,080 $75,040 $54,400; $87,810 $80,290 $100,550 $99,830 $122,110 $108,190 $105,030 $125,760 1,060 300 290 110 • Medical Billing and Coding: Hunter, Queens, Medgar Evers, NYC College of Technology and Lehman prepare students for the CCA and CPC certification exams.
• Medical Secretary/Office Administration: Queensborough’s Medical Office Administration includes three credits that can be applied towards the HIM Bachelor’s degree at the CUNY School of Professional Studies (SPS). • Associate degree program at the Borough of Manhattan Community College (BMCC): prepares students for the RHIT certification exam. This program is accredited by CAHIIM.
• Bachelor’s degree program at CUNY SPS: prepares students for the RHIA certification exam. This program is accredited by CAHIIM. • All credits from BMCC’s Associate degree program can be applied to the CUNY SPS Bachelor’s degree program.
• CCS certification can potentially be worth 18 credits. • CCA or CPC certification can potentially be worth 3 credits.
• All 36 credits from the CUNY SPS coding program can be applied to the CUNY SPS Bachelor’s degree program. Use these websites to learn more about health information jobs:• American Health Information Management Association (AHIMA), www.ahima.org • AHIMA New York City Chapter, www.himanyc.org • American Academy of Professional Coders, www.aapc.com • Healthcare Information Management Systems Society (HIMSS), www.himss.org • New York Health Careers, www.healthcareersinfo.net • National Cancer Registrar’s Association (NCRA), www.ncra-usa.org • National Healthcareer Association, www.nhanow.com • Commission on Accreditation of Health Informatics and Information Management Education, www.cahiim.org Funding was provided by the New York Alliance for Careers in Healthcare through a grant from the Leon Lowenstein Foundation. We would like to thank the following for their contributions and insights: Ellen Karl and Janet Mohlenhoff, CUNY School of Professional Studies; Shawna Trager and Hannah Weinstock, NYACH; Lynda Carlson, Borough of Manhattan Community College; Curtis Dann-Messier and Colette Labrador, CUNY Central Office; Sandi Vito, 1199SEIU Training and Upgrading Fund; Annie Wiseman, Institute for Family Health; Rosa Agosto, Urban Health Plan; Judilyn Canete, MedStar Billing; Rachel Block, Health Information Technology Consultant; Dr. Kenneth Ong, New York Hospital Queens, Michael Carbery, Jenny Tsang-Quinn, and Brian Pisano, Maimonides Medical Center/Brooklyn Health Home. Content: Ronnie Kauder and Pamela Hoberman of the NYCLMIS. Design: coenprojekts.com BILLINGASSURING: ENTRY-MIDGATHERINGASSURING: MID-HIGHANALYZINGINFORMATION TECHNOLOGY COMPUTER SCIENCE/TECH/INFO SYSTEMS JOB TRAINING/ CONTINUING EDUCATION KEY HEALTH INFORMATION MGMT MANHATTAN QUEENS BROOKLYN BRONX SI BARUCH COLLEGE BOROUGH OF MANHATTAN COMMUNITY COLLEGE CITY COLLEGE GUTTMAN COMMUNITY COLLEGE HUNTER COLLEGE JOHN JAY COLLEGE SCHOOL OF PROFESSIONAL STUDIES GRACE INSTITUTE MANHATTAN EDUCATIONAL OPPORTUNITY CENTER STRIVE NEW YORK LAGUARDIA COMMUNITY COLLEGE QUEENS COLLEGE QUEENSBOROUGH COMMUNITY COLLEGE YORK COLLEGE BROOKLYN COLLEGE KINGSBOROUGH COMMUNITY COLLEGE MEDGAR EVERS COLLEGE NEW YORK CITY COLLEGE OF TECHNOLOGY OPPORTUNITIES FOR A BETTER TOMORROW SUNY BROOKLYN EDUCATIONAL OPPORTUNITY CENTER SUNY DOWNSTATE BRONX COMMUNITY COLLEGE HOSTOS COMMUNITY COLLEGE LEHMAN COLLEGE COLLEGE OF STATEN ISLAND MED. BILLING & CODING H.I.M. & E.H.R. MED SEC’Y/ OFFICE ADMIN. ASSOCIATE BACHELOR’S MASTER’S ASSOCIATE BACHELOR’S MASTER’S NOTE: THIS TABLE IS ACCURATE FOR THE 2014 - 2015 ACADEMIC YEAR. PLEASE CONSULT INDIVIDUAL WEBSITES TO EXPLORE CURRENT LISTINGS.
STACKABLE CREDENTIALS JOB TRAINING/CONTINUING EDUCATION HEALTH INFORMATION MANAGEMENT (HIM) WHAT PROGRAMS PREPARE PEOPLE FOR THE JOBS ON THIS CAREER MAP?