Medical Records Clerk

Summary:
Responsible for electronically completing the functions of imaging and/or importing medical record documents as well as performing manual operational duties as assigned to ensure the timely and accurate availability of patient information in accordance with government and accrediting regulations.

 

Responsibilities:
Demonstrates understanding of Hospital�s Mission Vision and Values.

Demonstrates understanding of job description performance expectations and competency assessment plan.

Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to our Customer Service Standards.

Complies with department and hospital policies and procedures.

- Reviews policies and procedures

- Reviews Employee Handbook.

Completes mandatory safety management education.

- Hospital-wide

- Department-specific

- Job-specific

Participates in departmental and/or interdepartmental quality improvement activities.

Demonstrates ability to locate and retrieve medical records from within Health Information Services and from nursing units for scheduled delivery or unscheduled requests.



Responds to requests for patients in need of transfer to another facility:

Coordinates the copying and preparation of medical record information for receiving facility and documents required information for recording in Release of Information system

Completes patient transfer sheet

Demonstrates ability to locate medical record numbers or patient names in the Patient Information Computer System.

Maintains and verifies medical record numbers and names i.e. baby�s in computerized and manual MPI systems.

Performs initial health care record processing examines non-bar-coded documents determines the proper document type and adds barcode stickers to the forms or inserts DIP pages as needed.

Prints Patient Index Pages for the proper patient and account number and adds them to the correct chart for Electronic Document Management Processing.

Prepares records and loose documents for scanning utilizing hi-speed scanner and base scanner to scan documents into the imaging system.

Ensure that images meet quality standards for indexing and re-scan as necessary.

Follows up on missing records to ensure they are received and processed in a timely manner according to procedure.

Sorts loose medical record documents in preparation for scanning

Achieves and maintains established accuracy standards.

Achieves and maintains established productivity standards

Reports indexing discrepancies to the Health Information Systems Manager for resolution.

Utilizes the Medical Record Tracking System to:

Identify and enter reports needing signatures

�Move� and sign charts in and out of the department

Locate medical records

Provides providers with deficient information and medical record content requirements.

Demonstrates understanding of Hospital policy and State statutes rules and regulations pertaining to:

- Preparation completion and filing of birth certificates and fetal death certificates

- Rights of minors and/or unmarried individuals regarding filing of birth certificates and completion of affidavits of paternity papers.



Promptly informs HIS Systems Manager or HIS Director of system and/or user concerns.

Answers main department telephone line according to procedure to ensure prompt customer service.

Demonstrates ability to check for medical record requests in SoftMed system.

Able to check for dictated reports in the eScription Dictation System.

Identifies and processes medical records containing information requiring State and Federal reporting including suspected child abuse/neglect and Workers� Compensation injuries.

Prepares and reports required volume and productivity statistics in complete accurate and timely manner.

Performs other related duties as directed.

 

Other information:
Qualifications:

High school diploma and ability to operate computer terminal for data entry and retrieval.



Limited knowledge of medical terminology.



Physical Requirements:

Must be able to sit for 3-7 hours stand walk and squat/kneel 1-3 hours per day with infrequent bending and twisting.



Must be able to lift 10-35 lbs with good body mechanics.



Use both hands/wrists and perform work with moderate deviation from neutral position with moderate � frequent hand/wrist repetitions; able to perform gross motor skills.



Requires accurate near/far vision color discrimination and depth perception.



Must be able to hear whisper at 3 feet.

 

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Lifespan is a VEVRAA Federal Contractor.

 

Location: Newport Hospital USA:RI:Newport

 

Work Type: Part Time

 

Shift: 1

 

Union: Non-Union