Medical Record Specialist

Rush Memorial Hospital•Rushville, IN

About The Position

The Medical Record Specialist scans and imports clinical documents into the hospital’s electronic health record system, analyzes closed records for chart completion, assists with release of information, and supports other department duties. The role involves frequent interaction with the public and requires a customer-service-oriented, professional approach. The position works with confidential information and requires the ability to communicate with people inside and outside the hospital, work independently, exercise appropriate judgment, and complete duties with minimal supervision. The specialist performs documentation analysis of closed records for compliance with applicable Medical Staff Rules, Regulations and Bylaws, hospital policies, and state and federal guidelines. Additional work includes correcting the Master Patient Index, handling and checking documents, distributing documents for clinician signature, entering patient-expiration notifications when assigned, assisting with the department telephone line and release-of-information functions, and participating in the hospital’s quality improvement and emergency response activities. This is a full-time day position scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m. Work is performed in a clean, well-lighted, ventilated building with usually moderate noise. The employee may be exposed to infectious diseases and to cuts, abrasions, burns, or punctures. The schedule may vary according to the position’s responsibilities. The position reports to the Director of Health Information.

Requirements

High school diploma.
Demonstrated verbal and written communication skills.
Ability to use Microsoft Office Word, Excel, and Outlook calendar.
Ability to give and follow instructions accurately.
General working knowledge of medical terminology.
Ability to work with and communicate with different types of people.
Ability to work independently and make appropriate decisions regarding basic release-of-information processes.
Ability to complete assigned duties with minimal supervision.
Ability to prioritize, use critical thinking, and adjust to changes in work assignments.
Logical reasoning and problem-solving skills.
Ability to use independent judgment and initiative when handling unusual situations.
Ability to read, write, and perform simple calculations.
Ability to follow written and oral instructions.
Detail orientation, time management, and ability to manage multiple tasks.
Ability to work under a moderate amount of stress.
Ability to meet the physical and mental demands of the role, including walking, standing, sitting, using hands, reaching, talking, hearing, and frequent lifting of up to 25 pounds.
Close vision, distance vision, and ability to focus.

Nice To Haves

Completion of a medical terminology course of study.
At least one year of previous health information, clinical, office, legal, or related experience.

Responsibilities

Scan and import clinical documents into the hospital’s electronic health record system accurately and in a timely manner.
Analyze closed records to assess chart completion and compliance with applicable guidelines.
Make corrections in the Master Patient Index as necessary.
Perform document pickup, drop-off, sorting, and second-checking duties as assigned or needed.
Distribute paper and/or electronic documents for clinician signature as necessary.
Enter notifications in patient electronic health records upon notice of patient expiration, as assigned.
Assist with answering the department’s main telephone line.
Assist with release-of-information functions.
Assist with other department duties and perform other duties as assigned.
Maintain effective communication with other employees and take appropriate action in problem situations.
Project a professional and positive attitude regarding the hospital and department.
Follow hospital dress guidelines, wear hospital-issued identification, provide proper absence notification, and arrive punctually.
Participate in emergency procedures, fire drills, evacuation procedures, and other disaster response.
Support the hospital’s mission, vision, and values.
Participate in quality improvement by bringing potential problems to the appropriate person’s attention, assisting with data collection, suggesting solutions, and supporting quality improvement practices.