The Healthcare Insurance Reciprocal of Canada (HIROC) is a trusted healthcare safety advisor, committed to offering a full spectrum of insurance, risk and claims management products and support.
HIROC knows healthcare as it’s the largest not-for-profit healthcare liability insurer in the country, with over 700+ healthcare organizations part of the Reciprocal. Combined with sage counsel and risk management solutions, HIROC works with its partners to increase safety.
As a Reciprocal, HIROC is governed by its Subscribers and remains an innovative, agile and proactive partner. Since its inception in 1987, the not-for-profit has returned over $200 million to the healthcare system. HIROC’s thirty-plus years of data is combined with its extensive experience to advise and share learnings, all with the goal of scaling knowledge and increasing safety across Canada’s healthcare system.
One common thread running through HIROC’s culture is the feeling of being part of something unique:
partnering to create the safest healthcare system – HIROC’s vision.
Each employee has the opportunity to find their calling and help build a stronger organization designed to meet the needs of its Subscribers. As a Top 100 GTA Employer five years running, HIROC employees are empowered to find solutions and create amazing experiences in service to its Subscribers.
Join us and be part of the team working to make a difference.
Duties and Responsibilities
Claim Review and Coding Tasks
- Review liability and property claims to identify clinical, risk, insurance and other information surrounding the incident which lead to the claim.
- Assign initial codes using ICD-10-CA, CCI, allegation, location, medication, property loss codes, etc. to accurately record the claim.
- Accurately and appropriately extract, capture and record data to improve HIROC’s coding capabilities.
- Regular coding audits and arrange regular coding meeting, and coder education.
- Assist in maintenance of administrative data and integrity of records.
- Liaise with adjusters/subscribers in gathering data related to the release, storage copying and transferring of health information in electronic health records, portals, etc.
- Maintain the HIROC coding manual, including coding conventions based upon claim type.
- Maintain strict confidentiality of all patient information in accordance with PHIPA.
Analysis and Preparation of Report Tasks
- Coordination and evaluation of audit processes to ensure quality and integrity of coded data.
- Assist in the development and production of ad-hoc/or standard reports related to identified risks.
- Assist in education and informational analysis to external stake holders (e.g. CMPA).
- Analyze data using various software tools, present information and express complex ideas clearly and effectively to various audiences.
- Provide oversight and assist in improving the quality of data and information as appropriate including audit of data processes.
- Assist in the preparation of supplemental Partnership reports including risk management issues and trending.
- Collaborate with IT Business Analyst to ensure all required components are available and develop risk management reports.
- Participate in ongoing educational opportunities to remain current on issues in the field of health information and risk management.
- Contribute to Risk Assessment Checklists development, bringing forward trending and significant claims data.
- Review and edit tools and resources (i.e. Risk Reference Sheets, Case Studies, Risk Notes, Infographic, etc.)
- Participate in/lead ad hoc HRM and HIROC projects, initiatives and committees.
- Facilitate continuing education for CHIMA members. This may include being preceptor for CHIM students of an accredited college.
- Other duties as required.
Skills and Attributes Required
- Attention to detail.
- Well-developed statistical and data analysis skills.
- Proficiency in computer skills with special emphasis on the Microsoft Office suite of tools, specifically Excel including familiarity with pivot tables.
- Ability to work under pressure and meet deadlines.
- Ability to work independently and as a team member.
- Willing to demonstrate initiative.
- Good time management skills.
- Excellent written, verbal and listening skills.
- Graduate from a recognized Health Information Management/Professional program.
- Qualification in a Health Information Management Program or Nursing Program or other health discipline.
- Certification with the Canadian Health Information Management Association in good standing is required.
- Minimum 3 years of previous experience in coding required.
- Demonstrated coding competency in ICD-10-CCA/CCI coding.
- Excellent knowledge of medical terminology.
As a condition of employment, all external hires will be required to submit proof of COVID-19 vaccination or documentation unless a valid medical exemption or a valid exemption based on enumerated grounds under the Ontario Human Rights Code exists. All internal candidates must be in compliance with HIROC's COVID-19 Vaccination Policy.
How to Apply
Please submit your résumé to HR@hiroc.com.
In order to be considered for this position, please include a current résumé or detailed qualifications summary with your application. Only those selected for an interview will be contacted.
HIROC is committed to providing a barrier-free environment for all stakeholders, including our Subscribers, employees, job applicants, suppliers, the public and any visitors who may enter our premises, access our information, or use our services. As an organization, we respect and uphold the requirements set forth under the Accessibility for Ontarians with Disabilities Act (AODA) and its associated standards and regulations and will ensure that we offer a safe and welcoming environment that is respectful of each person's dignity and independence.
As an organization, HIROC is dedicated to meeting the needs of individuals with disabilities in a timely manner. We understand that providing a barrier-free environment is a shared effort, and as an organization, we are committed to working with the necessary parties to make accessibility a reality for all.