Medical Records Assistant

Medical Records Assistant

• Must have Point Click Care (PCC) experience

POSITION SUMMARY

The purpose of your job position is to maintain resident medical records and health information in accordance with current federal, state, and local guidelines that govern the facility and as directed by the supervisor and / or Administrator.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Assisting the Director of Medical Records as required

Retrieving resident’s records (manually / electronically) and deliver if necessary

Ensuring incomplete records are returned to appropriate department for corrections

Managing accurate and timely requests of medical records

Assembling, collecting and reviewing resident’s medical records as needed

Ensuring the filing of all medical reports, doctors and nurses notes, x-ray, lab, etc.

Pickup up and delivering medical records from nurse’s stations

Maintaining a record of authorized information released from charts / records.

Indexing medical records

Keeping active and inactive medical records as warranted by company policy.

Protecting each resident's file and data with confidentially per HIPAA standards

Abiding with all facility policies and procedures including not disclosing user ID codes and passwords

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies these are the only duties you will be required to perform as directed by management. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

REQUIREMENTS

Education / Licensure

High school diploma or GED

Knowledge of medical terminology, coding, indexing and legal aspects of health information helpful

Qualifications / Experience

Minimum of 6 months medical records experience preferred

Ability to use computer data base for medical records

Able to type 45 words per minute

Excellent verbal and written skills

Knowledge of Point Click Care helpful

Working Conditions

May encounter frequent interruptions

May be involved with residents, family and government agencies

May be requested to work beyond scheduled working hours at times

Is subject to call back during emergency conditions (e.g., severe weather, evacuation, post disaster, etc.)

May be necessary to assist in the evacuation of residents during emergency situations

May be exposed to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses

Physical Requirements

Must be able to move intermittently throughout the day

Repetitive hand motion

Must be able to push, pull, move and or lift up to 25 lbs. to a minimum height of 5 feet and be able to push, pull, move,

and / or carry such weight a minimum distance of 15 feet

Ability to read fine print on progress notes and / or medical labels