POSITION TITLE: Office Specialist (Data Entry)
DESCRIPTION: Under the immediate supervision of the CALM Unit Director, this position duties related to the maintenance and control of client records.
MINIMUM QUALIFICATIONS:
Qualifications: - High School diploma or equivalent - Minimum six (6) months prior experience in a clinical environment working with electronic medical records preferred - Excellent oral and written communication skills - Basic mathematical alphabetizing skills – Good Microsoft Office skills - Good organizational skills - Demonstrates courteous manner on telephone and in person - Ability to address job duties with numerous interruptions.
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES:
- Basic computer knowledge and basic ability to use Microsoft software – email, Excel spreadsheets and Word.
- Ability to use a computer keyboard.
- Good oral and written communication skills.
- Ability to stand or sit and scan documents into the electronic medical record system.
- Ability to indexing records into the proper location within the EHR.
- Ability to identify where various documents will go within the EHR system.
- Ability to establish and maintain professional working relationships with clients, administration, clinical staff, support staff and the general public.
- Ability to maintain the strictest confidentiality guidelines for interactions regarding client information.
- Ability to communicate and interface with clients, administration, clinical staff, support staff and the general public in a clear, polite and respectful manner at all times both in person and on the telephone.
- Ability to spell accurately.
- Ability to count, add, subtract, multiply, divide, and calculate charges.
- Ability to compose letters and other correspondence in a professional manner.
- Ability to answer the telephone.
- Ability to complete job tasks with interruptions and changing priorities.
- Ability to work well under pressure meeting deadlines with efficiency and consistency while maintaining a balance between good physical and mental health and the job requirements.
- Must be able to travel from one CRSOK office to another on occasion in order to perform various medical record maintenance and review activities.
- Supports and promotes a service environment for individuals in need of behavioral health and/or co-occurring services that is recovery focused, welcoming, and attentive to the needs of individuals who may have experienced trauma in their lives.
1. File or scan all information into paper or electronic medical records according to the approved record filing order (including lab, outside records, correspondence, progress notes, and other loose reports). (Domains A, C)
2. Scan paper documents into electronic health record system meeting daily requirements for records to be current. (Domains A, C)
3. Prepare new charts, repair or replace damaged charts, thin charts and prepare new volumes for long term clients as needed. (Domains A, D)
4. Assists with archiving charts as necessary (Domains A, D)
a. Archives charts according to the record retention program. Updates retention dates for readmitted clients, disclosures and other regulatory purposes.
5. Retrieve records from off site storage for release of information, readmits, and other reasons according to procedure. (Domains A, D)
6. Updates client information in the electronic health record; including but not limited to client demographics and discharge information. (Domain A, C, and D)
7. Processes release of information requests (Domains A, B, C, D):
a. Process release of information requests according to procedure and in accordance with state and federal regulation.
b. Assists clients and staff with proper completion of consent to release information forms.
8. Maintains accurate disclosure logs, both in EHR and Excel spreadsheet (Domains A, B, C, D).
9. Pulls and files charts. (Domain A)
10. Processes chart closures according to procedure (Domain A)
11. Maintain an accurate chart tracking system; assures records are returned to the department according to procedure. (Domain A)
12. Verify the identity of staff receiving records prior to checking the charts out of the department or allowing electronic access. (Domain A)
13. Locates misfiled charts. (Domain A)
14. Maintains a neat and orderly work area. (Domain E)
15. Conduct review of client records to assure information is recorded according to the
a. standards for medical record documentation. (Domain A)
16. Complete paperwork and turn it in a timely manner. (Domain D)
17. Maintain an adequate level of supplies in the department. (Domain D)
18. Trains employees/students/others the department procedures such as scanning, release of information, chart order, check out procedures, etc.). (Domain B)
19. Covers the reception desk duties when needed. (Domain B).
20. Perform other duties as assigned by the Medical Records Director. (Domain B, E)
21. Attend and participate in mandatory, agency, and team meetings. (Domain E)
22. Arrive at work on a timely basis and committed to work schedule. (Domain E)
23. Practices and promotes the Sanctuary model seven commitments: nonviolence, emotional intelligence, social learning, open communication, social responsibility, democracy and growth and change (Domain C).
24. Audit open CALM charts for any chart deficiencies and notify appropriate staff of needed corrections. Domain A, C, D,E
25. Assists with therapist, nurse, and/or discharge planner in completing discharge process and ensuring signature acquisition (e.g., ROI’s, consents, etc.) Domain A, C, D,E
26. Review active “Dashboard” status for bed status, intake/discharge status, school enrollment status and update and preparation of auditing needs. Domain A, C, D,E
27. Regular auditing of CALM closed charts for deficiencies and notification to appropriate staff of needed corrections. Domain A, C, D, E
28. Track Employee completion of chart deficiencies. Domain A,D,E
29. Schedule monthly CPR, First Aid, Food Handlers and TherOps training for staff’s annual training update in collaboration with CALM Unit Director. Domain A,D,E
30. Coordinate review of Relias/Annual training needs for CALM Staff, collaborate with CALM Lead LSC and CALM Unit Director on communication of training needs to team members, and review completion of trainings in preparation for annual audits/certification reviews. Domain A,B, D,E
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Upon request of unit nurse, CALM Lead LSC, or CALM Unit Director, assist with resident support and coverage on unit as needed to maintain appropriate licensing ratio, support of team, and assist with resident searches. Domain A, C, D, E.
PHYSICAL REQUIREMENTS: Must be able to move from location to location within the department and the facility, bend at waist, reach above the head, stoop, kneel, and lift 10 pounds. Must be able to communicate both verbally and in writing. Must be able to read medical records, both paper and electronic. Must be able to present information to other employees and clients, process complex information within established procedures/programs, and enter data into various computer applications.
- Annual Workplace Violence
- Annual Safety & Fire Training
- Annual Diversity Training
- Annual HIPAA and Confidentiality Training
- Corporate Compliance and Ethics
- Initial and Recertification Therapeutic Options Training
- Detox Signs and Symptoms Training
- Sexual Harassment/Discrimination – Prevention for Employees
- HIPAA and Behavioral Health
- Infection Prevention - Full Series
- Workplace Emergencies and Natural Disasters: An Overview
- Trauma Informed Treatment for Children with Challenging Behaviors
- Sanctuary Initial and Booster Trainings
HIPAA: This position is permitted to access confidential client information, paper and electronic, without authorization and unsupervised. Information shall only be accessed on a need to know basis, in the scope of the job responsibilities.
Safety Sensitive:
Counseling & Recovery Services of Oklahoma has designated this position as “safety-sensitive.” Employees who work in positions classified as “safety-sensitive” can be disciplined if they test positive for marijuana or its metabolites. Possession or use of medical marijuana while at work or during the hours of employment regardless of whether the employee has a valid Oklahoma medical marijuana license, is still strictly prohibited.
REPORTS TO: The CALM Center Unit Director; collaboration with HIM Director and HR Coordinator
EMPLOYMENT STATUS: Non exempt
SUPERVISES: None
HOURS: 40 hours per week. Mon-Fri 11:00am-7:00pm or 12:00pm-8:00pm.
