Full-time HIM Clerk

Lexington Regional Health Center•Lexington, NE

4d•Onsite

About The Position

The Health Information Management Clerk is responsible for preparing and scanning charts into the electronic medical record system, reviewing medical records for completeness, responding to requests for protected health information in accordance with HIPAA, collecting and entering data for birth and death certificates, and abstracting information from medical records. This role also involves monitoring deficiencies, ensuring patients and visitors follow infection control guidelines, maintaining a safe environment, and adhering to patient safety protocols. The position requires regular attendance and performance of all other assigned duties.

Requirements

Ability to use standard office equipment and computer software proficiently.
Ability to read, analyze, and interpret reports, general business directives, policy and procedure statements, and governmental regulations.
Ability to complete reports and correspondence at a professional level.
Ability to maintain strict confidentiality with regard to protected and sensitive information.
Ability to solve problems independently and confidently by applying analytical and logical thinking.
Ability to immediately respond to common inquiries and complaints from patients, employees and regulatory agencies.
Ability to effectively communicate with individuals from diverse backgrounds.
Ability to effectively organize and present information and respond to questions from employees and external groups of varying sizes.
Successful completion of required knowledge and training of standard precaution protocols and when to apply during principle duties and responsibilities.

Nice To Haves

Completion of a high school diploma or equivalent.
At least one year of experience in the health information management field is preferred.
Medical terminology knowledge preferred.

Responsibilities

Prepare charts for scanning and scan charts into electronic medical record system, sorting charts by documents and placing them in chronological order.
Review medical records for completeness, ensuring all necessary documentation is completed and all required fields have been signed. Apply electronic deficiencies when necessary.
Respond to requests for copies of protected health information in accordance with HIPAA privacy regulations, analyzing authorizations for HIPAA compliance and determining the appropriate medium for record release.
Answer the main office telephone.
Collect and enter data for birth certificates.
Collect and enter data for death certificates.
Work in collaboration with other Health Information Management employees.
Abstract information from the medical record for chart review.
Monitor deficiencies and notify visiting specialists if they have deficiencies for completion.
Ensure patients and visitors follow current infection control guidelines.
Responsible for ensuring the environment meets appropriate governing body standards.
Perform duties that could include blood exposure and risk to bloodborne pathogens (e.g., lacerations, handling of blood-contaminated items, etc.).
Maintain patient and staff safety through the use of patient safety tools (Teamstepps, Just Culture, etc.).
Regular attendance at the assigned work location is required.
Perform all other duties as assigned.