Job DescriptionTemporary positionEvening scheduleApproximately 5-10 hours per weekMAIN FUNCTION:Responsible for maintenance, filing, storage, retrieval and identification of medical records. Also responsible for chart completion and release of protected health information (PHI) in accordance with Federal Regulations such as HIPAA, New York State Law, and Arnot Health Policy. Reports to the HIM Manager as designated by the Systems Director of HIM.DUTIES AND RESPONSIBILITIES: 1. Maintains file management of all medical records: files records, retrieves records, and purges/prepares records for storage media. Responsible for organization of the main file room. 2. Performs chart assembly process including scanning of records. 3. Performs a detailed/complete review of both the electronic portion and hard copy portion of the medical record for completion of all discharge charts. Identifies, flags, and lists all chart deficiencies and assigns them to the responsible provider to comply with chart completion standards and regulations. 4. Pulls charts for providers by printing deficient chart lists from the Hospital Clinical System and maintains incomplete area. Assists physicians with chart completion as needed.
Reviews Hospital Clinical System and Dictation/Transcription Systems for dictation reports. Prints and/or interfaces the reports as necessary.
Manages the provider suspension process by:
· Initiating and distributing warning and suspension letters.· Filtering and removing letters as appropriate.· Contacting providers via phone and or qliq prior to suspension and maintaining documentation as to such communication.· Gather suspension information for the suspension list to be generated.· Remove providers from the list as appropriate and contact appropriate offices.
Utilizes the Hospital Clinical System for proper chart tracking including:
· Locate charts.· Sign-out charts.· Check charts into the correct location.
Supports Transcription services by running batch reports, interoffice distribution of reports, mailing of reports to external offices/facilities, assisting with phone calls and addressing issues within abilities and relaying calls to the Transcription Supervisor or Transcription Team as appropriate.
Reviews the AMS/Physician Office RAI (Request for Additional Information) list to assist with hospital-based documentation and assigning deficiencies in the Hospital EHR when appropriate and communicating with AMS when RAIs are resolved.
Places loose filing to the medical records as appropriate: dictation records, ancillary reports, etc.
Answers phones, pulls charts for physicians, units, and ancillary personnel as requested.
Responsible for keeping HIM Supervisor abreast of status of incomplete records and identifies areas of concern for delinquent medical records.
Assists customers with completion of Authorization forms, but does not release records to patient unless directed by the Correspondence Coordinator. Authorized to release medical information to healthcare provider and facilities in medical emergencies or as delegated by coordinator.
Processes medical records completed by providers. Reviews charts and identifies charts to be filed complete. Performs final editing and review of chart before leaving the incomplete area. Makes appropriate updates in the Hospital Clinical System.
Purges charts for archiving and maintains archive log documenting charts that have gone to off-site storage.
Stays abreast of all current state, federal, and other regulatory agency requirements of medical records documentation.
Provides coverage for clerical area:
· Answer phones· Wait on physicians in the incomplete chart area· Pulls charts as requested by units and Emergency Department· Runs Pull Lists and/or ADT sheets as appropriate.
Maintains confidentiality of all medical record information.
Employee understands and demonstrates the importance of satisfying the needs of the customer/patient by interacting with him/her in a friendly and caring way, being attentive to he customer’s needs, both psychologically and physically, and by taking the initiative to maintain communication with the customer in order to provide a secure and pleasant experience with the Arnot Health.
Is responsible for attending mandatory educational programs as required by position
It is understood that this job description lists typical duties for the classification and is not to be considered inclusive of all duties, which may be assigned.
EDUCATION: High School graduate preferred. Medical Office Assisting, Health Information Technology, or comparable degree or certification preferred.EXPERIENCE: 1-3 years’ medical office/unit experience required. Computer experience required. Health Information Technology Accreditation preferred.CARDIOPULMONARY RESUSCITATION (CPR) REQUIREMENTS:No CPR required.PHYSICAL DEMANDS: Moderate physical effort. Frequently lift 30 lbs. On feet a moderate amount of time.EXPOSURE CATEGORY:Category III. Tasks that involve no exposure to blood, body fluids, or tissues. Category I tasks are not a condition of employment.Requirements
