What are the responsibilities and job description for the Medical Records Clerk position at Fiesta Park Wellness and Rehabilitation?
Objective
Under the direction of the Director of Nursing or Medical Records Director (if applicable) and with consultation from the Medical Records Consultant, the Medical Records Clerk maintains the medical records in accordance with State and Federal Regulations as well as professional standards of practice and facility policies and procedures to ensure complete, timely, and accurate medical records. The Medical Records Clerk is responsible for managing all aspects of the medical patient record from admission to discharge.
Principal Responsibilities
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Under the direction of the Director of Nursing or Medical Records Director (if applicable) and with consultation from the Medical Records Consultant, the Medical Records Clerk maintains the medical records in accordance with State and Federal Regulations as well as professional standards of practice and facility policies and procedures to ensure complete, timely, and accurate medical records. The Medical Records Clerk is responsible for managing all aspects of the medical patient record from admission to discharge.
Principal Responsibilities
- Assembles, protects and collects records
- Monitors physician visits and documentation
- Thins paper record
- Tracks incomplete records
- Produces record on request according to corporate guidelines
- Manages orders
- Performs Quality Assurance Performance Improvement (QAPI) checks for completeness and accuracy
- Performs any miscellaneous work assignments as may be required.
- High school diploma required; Associates degree in Medical Record Technology preferred; Completion of classes in medical terminology and knowledge of HIPPA.
- One to two years previous experience in medical records; previous typing and office experience preferred.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.