Medical Record Specialist – Chart Auditor

Medical Record Specialist – Chart Auditor

Full Time SCA Associates in Administrative/HR , in Technicians/Technologists Email Job
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Job Detail

  • Applicants Apply Externally No

Job Description

Facility DescriptionAdvanced Surgical Hospital, Washington PA, is a 14-bed inpatient orthopaedic specialty physician owned acute care hospital. Includes a 6,500 square foot Rehabilitation Department serving inpatient, outpatient physical and occupational therapy services.

Accountabilities / Responsibilities

Assembles, reviews, and maintains patient files and medical records in a confidential and accurate manner following established policies and protocols; supports activities of the clinical departments and business office.
Key Responsibilities:
  • Retrieves medical records promptly upon request for nurses, physicians, front office personnel, hospital floors, and/or other authorized individuals; tracks/monitors record’s location and return.
  • Identifies late, incomplete, or inaccurate documentation and, in accordance with established protocols, reports to individual(s) responsible for completion/accuracy of documentation; tracks return of such documentation.
  • Completes requests for medical records and validates the accuracy of the release of information form, documents released and person requesting the documents on all medical records requested. Invoices requestor when applicable.
  • Receives incoming medical records charts/documents and completes medical record audits utilizing a pre-defined checklist listing required chart documents while following state and government guidelines for completeness and accuracy.
  • Prepares for insurance and regulatory agency chart audits by pulling charts to be reviewed and assuring that charts are complete and in good order.
  • Verifies census daily to ensure medical record chart is received within a timely manner.
  • Utilizes hospital computer system effectively in order to complete jobs efficiently.
  • Completes weekly deficiency reports, productivity logs, etc.
  • Assists with data entry as needed; prepares reports and correspondence as needed.
  • Answers telephone and responds to requests/inquiries in a timely and professional manner as needed.
  • Accurately scans medical record documents and release of information documents into the EHR and verifies legibility.
  • Accurately files medical records in the Medical Records Filing Room and accurately files loose forms into the appropriate medical record.
  • Completes final Quality Check of the medical record before shredding chart.

Qualifications

  • High school diploma or equivalent preferred.
  • One to two years related experience or equivalent. Knowledge of medical terminology
  • and transcription guidelines and practices preferred.
  • Must possess good oral and written skills, must be able to communicate with hospital
  • contacts both on the telephone and directly, and effectively communicate with all age
  • groups, populations, and individuals within the hospital.
  • Must become familiar with the hospital computer system and office applications.

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