Medical Records Clerk

First Choice Community Healthcare•Albuquerque, NM

42d•Hybrid

About The Position

Under the supervision of the Health Center Manager, this position assembles and maintains complete medical records according to established procedures. The role involves filing and retrieving patient records, preparing new files, and potentially opening and distributing mail. The Medical Records Clerk ensures that all patient information is accurately maintained and accessible while adhering to strict confidentiality and quality standards.

Requirements

High School graduate or GED certificate
Three months related experience
Ability to work as a team member within a clinical environment.
Records maintenance skills.
Ability to develop and maintain filing systems.
Ability to complete routine paperwork.
Ability to maintain confidentiality of records and information.
Skill in the use of operating basic office equipment.
Ability to follow routine verbal or written instructions.
Ability to maintain quality, safety, and/or infection control standards.
Ability to maintain patient confidentiality.
CPR Certification within 6 months of hire.

Nice To Haves

Bi-lingual English/Spanish preferred

Responsibilities

Sorts and files loose paperwork in patient charts; maintains medical records in proper order.
Creates patient folders for new patients using unique identification numbers according to established protocols.
Combines non-original charts with original charts.
Retrieves patient charts on a daily basis for next day appointments and re-files charts in proper sequence.
Completes out guides for pulled charts.
Locates records that have been checked out or are missing, in accordance with policies for safeguarding patient records.
Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control standards.
May perform other routine clerical tasks.
Files x-ray, EKG and other reports according to health record order of assembly format.
Checks for errors in patients identification.
Pulls and screens health records for completeness, makes patient identification cards and re-files records upon completion of activities.
Sends medical records to appropriate destination either through fax, phone, or mail.
Charges appropriate fees if any for copies of medical record(s) and submit to Central Billing for further processing.
Completes dental charts for medical records where dental services are offered.
Checks encounter forms against medical record to assure conformity.
Audits medical records to ensure adequate documentation to patient encounter.
Checks encounter forms against sign-in list to see that no encounter forms are issued.
Assures that all statistical reporting forms (family and individual registration forms and encounter forms) are checked for accuracy to see that all categories are filled in.
Maintains daily census from sign-in list.
Archives medical records at the end of the year, by labeling, boxing, and utilizing the computer system to place notes and further research in the future.
Purges health records.
Obtains and releases medical information as directed by physician.
Performs miscellaneous job-related duties as assigned.