Job Description

Performs the essential duties and responsibilities and the primary function of Discharge Analysis. Analyzes medical records for Inpatient, Observation, and Same Day Surgery services. Utilized Hospital and regulatory documentation requirements and guidelines when screening the medical records for content and accuracy. Posts loose reports and retrieves patient records upon request. Assist co-workers with the HIM Department’s incoming telephone calls. Responsible for promoting teamwork with co-workers, physicians, and personnel from other departments. Responsible for solving practical problems dealing with a variety of issues and interpreting a variety of instructions furnished in written or oral form. Demonstrates clerical knowledge and judgment necessary to complete the job responsibilities. ESSENTIAL FUNCTIONS/PERFORMANCE EXPECTATIONS• Analyzed medical records for inpatient, observation, and SDS services for completeness, accuracy, and compliance with regulations. • Demonstrates the ability to use the Hospital Information System to enter, verify, and update information regarding the location of patient medical records. • Routes medical records to various locations within the HIM Department. • Communicates effectively (hear, listen, speak) with co-workers in the Health Information Management Department, physicians, other Health Team members of the Hospital, Administrative Staff, patients, families, and customers. • Respects and safeguards patient’s rights, confidential information and Hospital information. EDUCATION AND EXPERIENCE• A mental development equivalent to a high school graduate, capable of solving practical problems dealing with a variety of variables. • Prefer six months to one-year previous experience in the Health Information Management Department or related clinical setting. • Computer keyboarding experience and clerical experience. Knowledge of medical terminology helpful, but not required. PHYSICAL REQUIREMENTS To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to: • Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.