Medical Records Tech II

Medical Records Technician II

The Medical Records Technician II is responsible for providing support to authorized users of protected health information (PHI) by ensuring health information is indexed accurately, maintained in accordance with hospital policies and procedures in the electronic legal health record and that information is available in a timely manner. In addition, the Medical Records Technician II will review records for completeness, accuracy and compliance with regulations.

Primary Job Functions

• Retrieves, complies and maintains paper and electronic patient health records in a manner consistent with administrative, ethical, legal and regulatory requirements to meet hospital established DNFB standards.
• Assures patient records are forwarded from department to Health Information Management upon patient discharge. Follows up with departments requesting missing documents be completed and forwarded to Health Information Management. Ensures all discharged records are scanned accurately.
• Reviews health records post discharge identifying missing items such as signatures and reports. Follows through with locating and securing missing documents.
• Scans documents into the Electronic Medical Record (EMR).
• Maintains confidentiality in accordance with hospital policies and HIPAA privacy regulations related to release of information.
• Provides department telephone coverage. Reads and responds to e-mails in a timely manner.
• Other clerical duties as assigned.

The successful candidate will possess the following:

• High School Diploma or equivalent
• One (1) year Health Information Management clerical experience, acute care environment experience preferred
• Working knowledge of the Health Insurance Portability and Accountability Act (HIPAA) and able to effectively apply to all aspects of the position preferred
• Above average organizational skills with the ability to manage multiple tasks
• Demonstrated proficiency with Microsoft Office suite (primarily Word and Excel), with one or more years' entering data
• Experience with Electronic Medical Record (EMR) preferred
• Working understanding of basic office machines including fax, copier and scanner
• Must be able to communicate (speak and understand) English, including complex medical terminology
• Knowledge of medical terminology preferred
• Demonstrated success working in an environment requiring attention to detail