Position Summary: This position is responsible for analyzing and assembling medical records, assisting with requests for information and ensuring compliance with HIPAA privacy regulations and state and federal laws. Maintains the confidentiality of patient records. Participates in performance improvement activities of the department and daily management of infection prevention and control activities.
Standards of Behavior
Be loyal to my co-workers and the hospital and do not undermine other people’s work. Take initiative to do what needs to be done, not leaving it for someone else to do. Complete mandatory education on time, maintain appropriate licenses and other certifications as appropriate (such as BLS, ACLS, etc) and meet other basic requirements for my job.
Rudeness is never appropriate and effective communication can create more positive encounters.
Treat each other with courtesy and respect. Show caring and concern for our patients, visitors and families.
Focus on providing the highest quality of care and be creative in adapting actions and responses to improve the level of service we provide.
Provide a comfortable atmosphere for all customers. Strive to anticipate needs and react in a caring, professional manner to patients, families, physicians, and co-workers. Respond to service recovery opportunities and strive to meet the needs of others by using A GIFT. Use proper phone etiquette. Answer calls in three rings. Greet caller pleasantly stating name and department. Ask “How may I help you?”
1. Assists all walk-ins and telephone calls regarding requests for medical records. Processes release of information requests in accordance with HIPAA privacy regulations, state and federal laws, and department policies and procedures. Copies medical record for patients. Prepares records for mailing or faxing to physician offices.
2. Retrieves discharged patient charts from various hospital departments. Assembles and analyzes all charts. Pulls and files charts. Attaches loose filing to charts.
3. Assists physicians and hospital staff with chart completion and requests for information. Runs charts to hospital departments when requested. Pulls charts for physicians to complete. Reanalyzes charts after physician completion. Runs and distributes weekly physician delinquent letters. Tracks location of all charts.
4. Works cooperatively with other department staff and agencies to complete reports for billing. Performs anesthesia and oncology billing. Tracks pathology reports. Attaches ER physician dictation to ER charts. Monitors incomplete dictation for the ER coder.
5. Treats patients and families with dignity and respect. Ensures confidentiality of patient records. Interacts professionally with patients and families and provides explanations and verbal reassurance as necessary.
Other Duties As Assigned:
Accepts other duties/responsibilities as assigned.
High School diploma or equivalent preferred.
Previous medical records experience preferred.
Knowledge, Skills and Abilities:
Knowledge of Medical Terminology. Basic knowledge of computers. Must be able to read, write and communicate effectively in English. Demonstrates flexibility, ability to multi-task and effective organizational and interpersonal skills.