Description

Position Summary:

In keeping with our organization’s goal of improving the lives of the Residents we serve, the Medical Records Coordinator maintains the health records of all Residents in the facility and provides administrative support to the nursing department in accordance with federal, state and local regulations.

Principal Duties and Responsibilities:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Maintains the health records of all Residents in the facility in a secure manner and in compliance with federal, state and local regulations.
• Establishes, develops, maintains and updates filing system for the medical records department. Retrieves information and files when needed.
• Verifies and inputs diagnoses codes for new admission paperwork.
• Maintains forms and paper communications at Nursing Stations.
• Maintains up-to-date records of individuals allowed to view Residents records.
• Respond to requests for medical records from outside the facility.
• Types and designs general correspondences, memos, charts and tables in regard to Residents information. Proofreads copy for spelling, grammar and layout, making appropriate changes. Responsible for accuracy and clarity of final copy.
• Reports all hazardous conditions, damaged equipment and supply issues to appropriate persons.
• Assure that established infection control and standard precaution practices are maintained at all times. Follow established safety precautions when preforming tasks and using equipment and supplies.
• Maintains the comfort, privacy and dignity of Residents and interacts with them in a manner that displays warmth, respect and promotes a caring environment.
• Communicates and interacts effectively and tactfully with Residents, visitors, families, peers and supervisors.
• Answers and respond to call lights promptly and courteously when working in Residents care areas.
• Reports all Residents concerns to the appropriate department head.
• Maintains a high level of confidentiality in accordance with HIPAA guidelines at all times and protects confidential information by only providing information on a “need-to-know” basis.
• Attend and participate in meetings and in-services as directed or scheduled. Attends in-service and education programs and attends continuing education required for maintenance of professional certification or licensure (if applicable).
• Understands Infection Control and follows the Company’s Infection Control guidelines, such as hand washing principles, understanding of isolation and standard precautions, recognizing signs and symptoms of infection, demonstrating and understanding of the process for identifying and handling infectious waste and cross contamination, maintaining personal hygiene, and complying with OSHA standards in the workplace.
• Promotes and Protects Resident Rights by assisting Residents to make informed decisions, treating Residents with dignity and respect, protecting Residents’ personal belongings, reporting suspected abuse or neglect, avoiding the need for physical restraints in accordance with current professional standards, and supporting independent expression, choice and decision-making consistent with applicable laws and regulations.
• Perform other tasks as required.

Supervisory Responsibility:

This position has no supervisory responsibilities.

Requirements

Education, Training, and Experience:

• High school diploma or equivalent.
• Two years of experience in health record processing and maintenance preferably in long term care.

Specific skills, knowledge, and abilities:

• Excellent written, verbal, and interpersonal communication skills.
• Ability to pay extremely close attention to detail.
• Basic computer knowledge is required.