Medical Records Specialist

Arizona Department of Administration • Phoenix, AZ

7d • $16 - $17 • Onsite

About The Position

The Arizona Department of Veterans' Services (ADVS) is seeking an outstanding Medical Records Specialist to maintain medical records, both electronic and paper, in compliance with state, federal, and VA regulations and facility policies and procedures for the Arizona Department of Veterans Services – Phoenix location. This role is crucial in ensuring veterans receive the highest quality services.

Requirements

• Knowledge of Health Care
• Knowledge of Medical Terminology
• Knowledge of Regulatory standards
• Knowledge of Medical office practices
• Knowledge of Medical records maintenance and security paper and electronic
• Knowledge of ICD10 coding and indexing
• Knowledge of HIPAA rules and regulations
• Knowledge of Security rules and regulations
• Knowledge of Record retention and disposal
• Skills in Verbal and written communications
• Skills in Customer services
• Skills in Audit a medical record
• Skills in Analytical data
• Skills in Problem solving
• Skills in Attention to detail
• Skills in Data Entry
• Ability to Transcribe doctors’ orders
• Ability to Prioritize multiple tasks
• Ability to Maintain confidentiality
• Ability to Handle multi-line phone
• Ability to Set up and maintain files
• Ability to Coordinate and schedule meetings
• Ability to Use of office equipment
• Ability to Learn and implement the concepts and tools of the Arizona Management System (AMS)
• Ability to Maintain and protect confidentiality
• Required to drive on state business; must possess a current/valid Arizona driver’s license.
• Must be able to obtain and retain a fingerprint clearance card issued by the Arizona Department of Public Safety.
• Current Negative TB skin test (Mantoux skin test) within the last twelve months or a written statement from a physician, physician’s assistant or a Registered Nurse Practitioner indicating freedom from tuberculosis, if in the past has had a positive skin test or tuberculosis.

Nice To Haves

• Medical records experience in a skilled long term care facility

Responsibilities

• Ensure resident's face sheet is complete and accurately reflecting PHI contacts, independent travel privileges, motorized wheelchair use, alerts and escort communications within 24 hours of admission.
• Research hospital or transfer paperwork as necessary and add missing information to the face sheet electronic record, including diagnosis (ICD10) codes, allergies, code status, Living Wills and Power of Attorney, and contact information for physician, hospice, pharmacy, radiology, and laboratory provider.
• Ensure Pre-admission Screening and Resident Review (PASRR) is included with transfer paperwork. May transcribe orders from hospital/transferring facility into electronic record for verification by Nursing.
• Audit electronic records to ensure all observations are completed, consent forms are signed; medication reconciliation is complete; initial care plans are complete; orders are complete with the diagnosis, correct route, etc.; all psychotropic medications have behaviors with monitors and side effects orders; psychotropic medications have signed and dated consents for each with classification of each; AIMS is completed; additional ICD 10 diagnosis codes are added to medications as needed within 72 hours of admission.
• Add Pre-Hospital Medical Care Directive data to face sheet after assuring order for code status matches signed directive.
• Audit records for each admission and return at 7, 14, & 21 days to assure each interdisciplinary department has completed all observations with accuracy and closed them.
• Audit records at 21 days to ensure completion of full MDS & completion of all necessary care plans; audit records on an ongoing basis to ensure progress notes from clinic; consult visits are received in a timely manner; ensure accurate order entry including category and compliance with regulations, policies and procedures.
• Check for event and observation accuracy and completion.
• Notify appropriate members of the inter-disciplinary team regarding incomplete documentation and unverified or unsigned orders; collect documentation from unit box to fax/scan into the EMR and assign to individual resident Electronic Medical Record, including labs, x-rays, consult notes, consents, hospital transfer records, etc.
• Audit Medicare Certification/Re-certification for timeliness and completeness.
• Provide appointment reminders to residents within 3-7 business days prior to appointments.
• Ensure all signed documentation upon discharge are scanned and uploaded into Electronic Medical Record; complete all discharge tasks for all discharges.
• Respond to requests for medical records, maintaining compliance with state and federal HIPAA laws; ensure all requests are complete and accurate prior to the release of documents; print all documents required.
• If subpoena for records is received, contact the State of Arizona Office of Attorney General for their review and direction prior to release; fax/mail to requesting party per policy and HIPAA regulations.
• Conduct quarterly/annual audits of observations, events, orders, preventative health and care plans; conduct a variety of ongoing audits, including lab and radiology orders/reports, physician & nursing orders for accuracy of category, flow sheet & correct diagnosis, monitors and consents, resident weight and height.
• Updates physician visits in EMR; update face sheet as necessary.
• Schedule resident appointments, diagnostic testing, laboratory testing, dialysis, etc., schedule transportation to/from appointment both outside and to VAMC; contact insurance providers for authorization for appointments and transport.
• Initiate lab and x-ray requisitions based on orders and insurance requirements. Initiate requests and tracking process of consultation orders by gathering required documents, faxing, emailing and communicating with clinicians to obtain specialty appointments.
• Maintain unit calendars with laboratory scheduled, clinic appointments including dialysis and transportation arrangements.
• Run facility activity report daily to capture consult requests, labs and radiology orders. Fill out requisitions for consults, labs and radiology requests as needed. Attend and participate in a variety of meetings and in-service training.
• Learn, implement and monitor AMS methods; actively participate in AMS by attending Huddle board meetings and utilizing AMS concepts and tools for problem solving, work/process improvements and creating standard of work.
• Perform bi-annual in-service training on HIPAA for all staff meetings.

Benefits

• Pension for a lifetime
• Healthcare benefits for a lifetime
• Sick leave
• Vacation with 10 paid holidays per year
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Health and dental insurance
• Retirement plan
• Life insurance and long-term disability insurance
• Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed