Medical Scribe - Orthopaedics

Medical University of South Carolina • Charleston, SC

38d • Onsite

About The Position

The Department of Orthopaedics and Physical Medicine is seeking a qualified medical scribe. The Scribe accompanies the physician or licensed provider into the exam room, documenting in the EMR all aspects of patient care to include, chief compliant, history of presenting illness, physical exam and patient plan as directed by the provider. The role of the Medical Scribe in the department of Orthopaedics and Physical Medicine is to actively facilitate health care delivery in a clinical setting under the direction of a licensed healthcare provider. The Scribe is responsible for assisting the provider in patient care as well as provide administrative scribing services to ensure the highest quality patient care and experience within the clinical scope of a MSA.

Requirements

• High school diploma or equivalent.
• Experience in a healthcare environment.
• Excellent computer and typing skills.
• Strong verbal and written communication skills.
• Working knowledge of an electronic medical record application.
• Adept knowledge of medical terminology
• High attention to detail.
• Must be able to work under the direction of a physician.

Nice To Haves

• At least 6 months Certified Medical Assistant or Certified Medical Scribe preferred.

Responsibilities

• Accompanies the Licensed Provider into the exam room, documenting in the EMR all aspects of care to include, chief compliant, history of presenting illness, physical exam and patient plan as directed by the provider 25%.
• Records the words and activities of the provider-patient portion of the encounter in real-time in the EMR 25%
• Initiates patient order and referrals in the EMR under the direction of the provider and submits to provider for authorization. Searches for relevant information in the medical record 20%
• Develops and understanding of the providers practice patterns and key terms used by the provider to ensure efficient and accurate real time documentation of the patient visit 10%.
• Ensures patients are appropriately prepared for the encounter. Prepares/obtains patient medical records and other information/documentation pertinent to the encounter 10%.
• Other duties as assigned 10%.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED