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Career Story: Health Information Administrator For A Health Insurance Company

Health Information Administrator For A Health Insurance Company

Job Title: Health Information Administrator

Type of Company: A major American healthcare insurance provider.

Education: BS, Colby-Sawyer College (New London, NH)

Previous Experience: I worked in several hospitals in their Medical Records Department before moving to nontraditional jobs in private industry - Medical software, Data collection and analysis and health insurance

Job Tasks: I have worked for my current company for 19 years, for the first 15 of which I was the director of the Audit department. I managed over twenty RNs and Health Information (RHIA/RHIT) staffers who fanned out to hospitals to review patient medical records and audit what was written in the medical records, contrasting it with the information we'd received on our own. The main purpose was to appropriate any overpayments and, in fact, we recovered tens of millions every year. My staff was expert in billing and reimbursement, including Medicare billing rules.

The job also required me to understand data and how to get claims data on 20,000 members to a platform that could be accessed by the auditors. For the last four years I have been working as a Project Manager in our Clinical division. (If you like detail work this would also a good choice for you and there are several certifications you can get to become a certified project manager). A project manager is responsible for all the details of a project. We wanted, in our case, to reach out to all members who had recently been discharged from the hospital to see if they understood their discharge instructions from their doctor, our idea being to avoid having members readmitted to the hospital through costly oversights and misunderstandings. The project required identifying members, hiring nurses to call members and designing reports so we could know how successful our program was.

Best and Worst Parts of the Job: The best part of the job is no two days are ever the same. There is a lot of variety which I like; I would not like the same thing every day.

The worst part was managing a large staff and all the personalities that go with it. It was very rewarding to have a team be really successful but after 20 years it is refreshing to just be responsible for myself or the project I am managing.

Job Tips: If you are a detailed person or really like science or medical stuff, you may want to consider a job in Health Information. It is really an expanding field with electronic medical records, personal health records, ICD-10 and who knows what changes from the Health Care Reform that is currently being worked on by President Obama.

I knew in high school that I didn't want to work with patients but I really liked the the medical, anatomy and physiology classes a lot. It is a nice combination as you learn to understand what is written in the medical record, the legal side of that information, privacy and security of health information.

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You need to have a Bachelor’s degree to be qualified for this school.

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