Medical Scribe

Tri-City Medical CenterOceanside, CA

About The Position

Tri-City Healthcare District has been serving the North County region for almost 60 years and remains committed to providing high quality healthcare and community services for every individual we encounter regardless of race, color, ethnicity, gender, sexual orientation, disability or socioeconomic status. Our mission is to advance the health and wellness of the community we serve. In order to achieve our mission, we see, hear and listen to our front line healthcare workers, employees, medical staff and all community stakeholders in order to understand and meet our community’s needs. Position Summary : The medical scribe works to facilitate patient flow and ensure an accurate and complete medical record for each patient. The Medical Scribe assists the medical provider by accompanying them during the medical history-taking and exam, recording details of both into the medical record.

Requirements

  • Six months of Medical Scribe experience or related clinical training, required.
  • Strong medical terminology, required.
  • Strong writing skills, required.
  • Computer proficiency with Windows applications, required.
  • Ability to type a minimum of 45 WPM, required.
  • Ability to work under stress with interruptions and deadlines.
  • Ability to process verbal information and proceed accordingly.
  • Ability to follow complex instructions.
  • Ability to use basic math skills needed to write prescriptions and draw injections.
  • Ability to think logically and critically and come to a conclusion.
  • Ability to enter and retrieve data from a computer.
  • Ability to use the phone system, copier, fax and printers.
  • Ability to navigate the EHR system.
  • Ability to communicate with a high level of medical knowledge to patients, staff, management, Physicians and others.
  • Demonstrates a high level of medical knowledge in regards to patient care, office procedures, patient evaluation, medical terminology, OSHA regulations, etc.
  • Knowledge of CPT, ICD-9/ICD-10, and HCPCS coding.
  • Demonstrated awareness of the patient as an individual, with specific physical, psychological and spiritual needs.
  • Obeys and adheres to all policies and procedures outlined in the handbook
  • High School diploma or GED, required.

Nice To Haves

  • Experience with Electronic Medical Records, preferred.
  • Certified Medical Assistant, preferred.

Responsibilities

  • Maintains a safe, clean working environment, including unit based safety and infection control requirements.
  • Maintains a clean and organized work area.
  • Maintains working knowledge of orthopedic medical terminology and accepted abbreviations.
  • Understands and recognizes the physical exam process and has the ability to record exam details.
  • Computer proficient and able to quickly learn new applications.
  • Tracks patient care and improves patient flow.
  • Demonstrates a professional demeanor and recognizes privacy considerations for patients and families.
  • Displays flexibility in scheduling.
  • Calmly copes with a high pressure environment.
  • Records details of chief complaint, history of present illness, review of systems, past medical history, social history, family medical history, disease risk factors, medications and allergies.
  • Records details of physician exam, including pertinent positives and negatives, noted abnormalities and patient general condition.
  • Submits orders as desired by medical provider and checks constantly for results of those orders.
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