The Medical Records Clerk is responsible for assuring that completed records meet all regulatory and compliance standards and are readily accessible to staff.
- Maintains and closes medical records per policy.
o Reviews medical records in accordance with written criteria.
o Identifies and obtains missing chart information to include signatures from physicians and other pertinent personnel.
- Assures appropriate release of information from Hospice Care to other parties.
o Obtains a signed authorization.
o Copies the medical information requested.
o Mails or hand delivers the copies to individuals requesting information.
- Develops and maintains a master patient index.
- Works with clinical staff to assure timely and appropriate admissions.
- Purges the medical record once the case is closed, listing the groups of medical records, placing records in boxes and sending them to the archives.
- Provides agency administrative support to include, but not be limited to, answering phones, ordering supplies, and data collection and entry.
- Participates in the coordination of the patient’s hospice care and in the hospice’s quality assessment and performance improvement program.
- Conducts Medical Record audits as requested.
- Performs other duties as assigned.
- Consistently promotes company’s core values.
- Completes required Curo annual training.
- This is a safety-sensitive position.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
- Education: High School diploma
- Experience: Three years of experience in office work or working in a medical records department
- Licenses, Certifications and/or Registration: Current automobile insurance and valid driver’s license
- Equipment/Tools/Work-Aids: Must be able to effectively operate computer, facsimile equipment, copier and cell phone/beeper. Must have and maintain transportation to be used for work.
- Specialized Knowledge and Skills: Excellent organization, record keeping, filing, typing skills; good oral and written communication skills; documentation management
- Personal Traits, Qualities and Aptitudes: Must be able to demonstrate flexibility by performing a variety of tasks, often changing from one to another of a different nature without loss of efficiency or composure. Communicate effectively with people of all socioeconomic backgrounds. Responsible functioning in the work place, maturity, cooperation, flexibility, tact in dealing with co-workers and all members of the hospice team.
- Working Conditions: Office environment.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be requested by individuals with disabilities to allow them to perform the essential functions.
- Exchange information and communicate verbally and by written word
- Must be able to read, write, and comprehend English
- Demonstrate active listening skills
- Specific vision abilities include close vision, distance vision, depth perception, and ability to adjust focus.
- Ambulate on rough surfaces and climb stairs
- Sit for extended periods of time
- Occasional standing and walking
- Moderate bending, kneeling, crouching, reaching, pushing, and pulling
- Lift or move up to 25 lbs
- The ability to work in a constant state of alertness and safe manner.
- Maintains high standards of integrity and business ethics.
- Abides by company rules, policies and procedures, and applicable laws and regulations.
- Conducts self in an honest, ethical manner.
- Reports promptly any suspected violation of compliance standards via the open door policy.
- Reports to the Director of Operations.
- Receives clinical direction from the patient’s primary nurse.