dismissed H-1B Case: Healthcare Administration

iming &ta deleted to 
pevent clearly unw~ted 
invasion of personal privacy 
U.S. Department of Homeland Security 
20 Mass Ave., N.W., Rrn. 3000 
Washington, DC 20529 
U. S. Citizenship 
and Immigration 
Services 
PUBLIC COPY 
FILE: LIN 04 209 53 153 Office: NEBRASKA SERVICE CENTER 
 Date: JUL 2 1 2006 
PETITION: 
 Petition for a Nonimmigrant Worker Pursuant to Section 101 (a)(l S)(H)(i)(b) of the 
Immigration and Nationality Act, 8 U.S.C. 5 1101(a)(l S)(H)(i)(b) 
ON BEHALF OF PETITIONER: 
INSTRUCTIONS: 
This is the decision of the Administrative Appeals Office in your case. All documents have been returned to 
the office that originally decided your case. Any further inquiry must be made to that office. 
Robert P. Wiemann, Chief 
Administrative Appeals Office 
LIN 04 209 53 153 
Page 2 
DISCUSSION: The director of the service center denied the nonimmigrant visa petition and the matter is now 
before the Administrative Appeals Office (AAO) on appeal. The appeal will be dismissed. The petition will be 
denied. 
The petitioner is a long-term care facility that seeks to employ the beneficiary as a reimbursement specialist. 
The petitioner, therefore, endeavors to classify the beneficiary as a nonimmigrant worker in a specialty 
occupation pursuant to section lOl(a)(lS)(H)(i)(b) of the Immigration and Nationality Act (the Act), 
8 U.S.C. 3 1 101(a)(l 5)(H)(i)(b). 
The director denied the petition because the proffered position is not a specialty occupation. On appeal, 
counsel submits a brief. 
Section 214(i)(l) of the Act, 8 U.S.C. 5 1184(i)(l), defines the term "specialty occupation" as an occupation 
that requires: 
(A) 
 theoretical and practical application of a body of highly specialized knowledge, and 
(B) 
 attainment of a bachelor's or higher degree in the specific specialty (or its equivalent) 
as a minimum for entry into the occupation in the United States. 
Pursuant to 8 C.F.R. 3 2 14.2(h)(4)(iii)(A), to qualify as a specialty occupation, the position must meet one of the 
following criteria: 
(I) 
 A baccalaureate or higher degree or its equivalent is normally the minimum requirement 
for entry into the particular position; 
(2) 
 The degree requirement is common to the industry in parallel positions among similar 
organizations or, in the alternative, an employer may show that its particular position is 
so complex or unique that it can be performed only by an individual with a degree; 
(3) 
 The employer normally requires a degree or its equivalent for the position; or 
(4) 
 The nature of the specific duties is so specialized and complex that knowledge required 
to perform the duties is usually associated with the attainment of a baccalaureate or 
higher degree. 
Citizenship and Immigration Services (CIS) interprets the term "degree" in the criteria at 
8 C.F.R. 3 214.2(h)(4)(iii)(A) to mean not just any baccalaureate or higher degree, but one in a specific 
specialty that is directly related to the proffered position. 
The record of proceeding before the AAO contains: (I) the Form 1-129 and supporting documentation; (2) 
the director's request for additional evidence; (3) the petitioner's response to the director's request; (4) the 
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director's denial letter; and (5) the Form I-290B and supporting documentation. The AAO reviewed the 
record in its entirety before issuing its decision. 
The petitioner is seeking the beneficiary's services as a reimbursement specialist. 
 Evidence of the 
beneficiary's duties includes: the Form 1-129; the attachments accompanying the Form 1-129; the petitioner's 
support letter; and the petitioner's response to the director's request for evidence. According to this evidence, 
the beneficiary would have responsibility for provider reimbursement: contacting benefits providers to gather 
policy benefits and/or limitations and ensure that the service provided is reimbursable. The beneficiary will 
facilitate communication between the service unit and the billing department for acceptance or denial of new 
clients; provide detailed billing instructions to appropriate service unit and billing staff upon determining 
reimbursement requirements for clients. The response to the request for evidence elaborated on the proposed 
duties. The petitioner seeks to employ the beneficiary who holds the educational equivalent of a bachelor's 
degree in accounting. 
The director stated that the proposed position does not resemble a financial manager as that occupation is 
described in the Department of Labor's Occupational Outlook Handbook (the Handbook). The director stated 
that the petitioner's organizational chart reveals that it employs a controller, which is considered a financial 
manager. The director found the submitted job postings unpersuasive in establishing the offered position as a 
specialty occupation. The director concluded that the petitioner satisfied none of the four criteria outlined in 
8 C.F.R. fj 2 14.2(h)(4)(iii)(A). 
On appeal, counsel states that the proposed position is similar to an auditor, which the Handbook indicates 
requires a baccalaureate degree in accounting or a related field. The America's Career InfoNet, counsel 
maintains, indicates that an auditor requires a bachelor's degree. According to counsel, the offered position 
requires knowledge of regulatory, coding, and billing compliance; and involves preparation of custom 
revenue reports that the administrator will use to prevent mismanagement, waste, or fraud. Counsel states 
that the beneficiary will ensure records are accurate and controls are adequate to protect against waste and 
fraud, and will recommend controls for the computer billing system. The beneficiary must have knowledge 
of economic and accounting principles and practices, financial markets, banking, and the analysis and 
reporting of financial data, counsel contends. Counsel discusses the relevance of the Dictionary of 
Occupational Titles (DOT). 
Upon review of the record, the petitioner has established none of the four criteria outlined in 
8 C.F.R. fj 214.2(h)(4)(iii)(A). Therefore, the proffered position is not a specialty occupation. 
The AAO first considers the criteria at 8 C.F.R. $5 214.2(h)(4)(iii)(A)(I) and (2): a baccalaureate or higher 
degree or its equivalent is the normal minimum requirement for entry into the particular position; a degree 
requirement is common to the industry in parallel positions among similar organizations; or a particular 
position is so complex or unique that it can be performed only by an individual with a degree. Factors often 
considered by CIS when determining these criteria include: whether the 2006-2007 edition of the Handbook 
reports that the industry requires a degree; whether the industry's professional association has made a degree a 
minimum entry requirement; and whether letters or affidavits from firms or individuals in the industry attest that 
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such firms "routinely employ and recruit only degreed individuals." See Shanti, Inc. v. Reno, 36 F. Supp. 2d 1 15 1, 
1 165 (D.Minn. 1999)(quoting Hird/Blaker Corp. v. Sava, 7 12 F. Supp. 1095,1102 (S.D.N.Y. 1989)). 
In determining whether a position qualifies as a specialty occupation, CIS looks beyond the title of the 
position and determines, from a review of the duties of the position and any supporting evidence, whether the 
position actually requires the theoretical and practical application of a body of highly specialized knowledge, 
and the attainment of a baccalaureate degree in a specific specialty as the minimum for entry into the 
occupation as required by the Act. 
Counsel asserts, in part, that the court in Young China Daily vs. Chappell, 742 F. Supp. 552, 553 (N.D. Cal. 
1989) relied on the DOTS information regarding job duties and requirements. However, the DOT is not a 
persuasive source of information regarding whether a particular job requires the attainment of a baccalaureate 
or higher degree in a specific specialty, or its equivalent, as a minimum for entry into the occupation. A 
specific vocational preparation (SVP) rating is meant to indicate only the total number of years of vocational 
preparation required for a particular position. It does not describe how those years are to be divided among 
training, formal education, and experience, and it does not specify the particular type of degree, if any, that a 
position would require. 
The AAO routinely consults the Handbook for its information about the duties and educational requirements 
of occupations. Counsel's assertion that the offered position is similar to an auditor is not convincing. The 
AAO finds that the Handbook reveals that the offered position parallels a medical records and health 
information technician, which is described in the Handbook as follows: 
Every time a patient receives health care, a record is maintained of the observations, medical 
or surgical interventions, and treatment outcomes. This record includes information that the 
patient provides concerning his or her symptoms and medical history, the results of 
examinations, reports of x rays and laboratory tests, diagnoses, and treatment plans. Medical 
records and health information technicians organize and evaluate these records for 
completeness and accuracy. 
Technicians assemble patients' health information. They make sure that patients' initial 
medical charts are complete, that all forms are completed and properly identified and signed, 
and that all necessary information is in the computer. They regularly communicate with 
physicians and other health care professionals to clarify diagnoses or to obtain additional 
information. 
Some medical records and health information technicians specialize in coding patients7 
medical information for insurance purposes. Technicians who specialize in coding are called 
health information coders, medical record coders, coder/abstractors, or coding specialists. 
These technicians assign a code to each diagnosis and procedure. They consult classification 
manuals and also rely on their knowledge of disease processes. Technicians then use 
computer software to assign the patient to one of several hundred "diagnosis-related groups," 
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or DRGs. The DRG determines the amount for which the hospital will be reimbursed if the 
patient is covered by Medicare or other insurance programs using the DRG system. In 
addition to the DRG system, coders use other coding systems, such as those geared toward 
ambulatory settings or long-term care. 
Some technicians also use computer programs to tabulate and analyze data to improve patient 
care, control costs, provide documentation for use in legal actions, respond to surveys, or use 
in research studies. For example, cancer (or tumor) registrars maintain facility, regional, and 
national databases of cancer patients. Registrars review patient records and pathology reports, 
assign codes for the diagnosis and treatment of different cancers and selected benign tumors. 
Registrars conduct annual followups on all patients in the registry to track their treatment, 
survival, and recovery. Physicians and public health organizations then use this information 
to calculate survivor rates and success rates of various types of treatment, locate geographic 
areas with high incidences of certain cancers, and identify potential participants for clinical 
drug trials. Cancer registry data also is used by public health officials to target areas for the 
allocation of resources to provide intervention and screening. 
The beneficiary's duties are encompassed within those of a medical records and health information 
technician. The February 21, 2005 letter indicates that the beneficiary will serve as a resource for regulatory, 
coding, billing compliance; present changes in regulations and assist physicians and staff in complying with 
federal, state, and local regulations; perform orientation regarding regulations; review and report on physician 
compliance with coding and documentation guidelines; monitor reports on service lines; provide custom 
revenue reports; create and maintain pricing; and maintain the Medicare Waiver Form for clinical areas. 
These duties correspond to those of medical records and health information technicians, as they organize and 
evaluate these medical records for completeness and accuracy, code patients' medical information for 
insurance purposes, determine patients7 insurance and Medicare coverage, and improve patient care and 
control costs. 
The Handbook indicates that a medical records and health information technician is not required to possess a 
bachelor's degree in a specific specialty. It states: 
Medical records and health information technicians entering the field usually have an 
associate degree from a community or junior college. In addition to general education, 
coursework includes medical terminology, anatomy and physiology, legal aspects of health 
information, coding and abstraction of data, statistics, database management, quality 
improvement methods, and computer science. Applicants can improve their chances of 
admission into a program by taking biology, chemistry, health, and computer science courses 
in high school. 
The AAO's conclusion, based on the evidence of record and the Handbook's information, is that the 
petitioner fails to satisfy the criterion at 8 C.F.R. 3 2 14.2(h)(4)(iii)(A)(I), which is that a baccalaureate or 
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higher degree or its equivalent in a specific specialty is the normal minimum requirement for entry into the 
particular position. 
To establish the first alternative prong at 8 C.F.R. 3 214.2(h)(4)(iii)(A)(2) - that a specific degree requirement 
is common to the industry in parallel positions among similar organizations - counsel refers to job postings. 
The postings are not persuasive, however. Most of the companies differ in nature from the petitioner, a small 
long-term care facility, or their nature is not revealed in the posting. Jackson-Madison County General 
~os~ital is a hospital; Scripps is a non-profit community-based health care delivery network with 10,000 
employees; University of Pittsburgh Medical Center is a large integrated health care delivery system with 
37,000 employees; and Bluecross Blueshield of Illinois is a large insurance company. University Health 
System and the Omaha Medical Facility (job reference: 04-65695) are not described in their postings. The 
Woodhaven Healthcare Services posting reveals that this company does not require a bachelor's degree. It is 
for these reasons that the job postings fail to establish that a specific degree requirement is common to the 
industry in parallel positions among organizations similar to the petitioner. 
The petitioner has not satisfied the second alternative prong at 8 C.F.R. fj 214.2(h)(4)(iii)(A)(2) as no 
evidence in the record shows the proffered position is so complex or unique that it can be performed only by 
an individual with a degree. Based on the description of the proposed duties, the AAO finds that the duties 
mirror those of a medical records and health information technician, which is an occupation that the 
Handbook reveals does not require a baccalaureate degree. No evidence in the record indicates that the 
offered position has such complexity or uniqueness as to require a baccalaureate degree in a specific 
specialty. Consequently, the petitioner fails to establish the second alternative prong at 
8 C.F.R. fj 214.2(h)(4)(iii)(A)(2). 
No evidence in the record establishes the regulation at 8 C.F.R. fj 214.2(h)(4)(iii)(A)(3): that the petitioner 
normally requires a degree or its equivalent for the position. 
To satisfy the regulation at 8 C.F.R. 8 214.2(h)(4)(iii)(A)(4/, the petitioner must establish that the nature of 
the specific duties is so specialized and complex that the knowledge required to perform the duties is usually 
associated with the attainment of a baccalaureate or higher degree. In light of the proposed duties, the AAO 
finds the offered position mirrors that of a medical records and health information technician, which is an 
occupation that the Handbook reveals does not require a baccalaureate degree. No evidence in the record 
indicates that the nature of the proposed duties is so specialized and complex that the knowledge required to 
perform the duties is usually associated with the attainment of a baccalaureate or higher degree. Accordingly, 
the petitioner fails to establish the criterion at 8 C.F.R. fj 214.2(h)(4)(iii)(A)(4). 
As related in the discussion above, the petitioner has failed to establish that the proffered position is a 
specialty occupation. Accordingly, the AAO shall not disturb the director's denial of the petition on this 
ground. 
The burden of proof in these proceedings rests solely with the petitioner. Section 291 of the Act, 8 U.S.C. 8 1361. 
The petitioner has not sustained that burden. 
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ORDER: 
 The appeal is dismissed. The petition is denied.