Job Details

HIIM Clerk I - Medical Records

Full-Time  - 8:30A to 5P

Role/Position Definition: To maintain medical records in accordance with Federal, State, and regulatory guidelines as well as hospital and HIIM policies and procedures; to assure that an accurate and complete medical record is maintained.

Duties & Responsibilities: In accordance to departmental standards and time frame in a consistently accurate manner will: 

1. Process patient medical information including prepping/assembling, scanning/filing, retrieving, and routing of electronic or paper documents. 
2. Loose sheet filing on a daily basis.
3. Run reports as needed to perform daily medical record duties. 
4. ROI – Assists in looking up file system, dates, and visit numbers. 
5. Assists with MR Billing Report – RTC.
6. Daily duties – answer phones, check faxes, make office calls, update call log, all other duties as assigned.
7. Validates that all documents are properly found within document imaging system. 
8. Analyzes electronic/paper medical records for chart completion.
9. Fax operative records to doctor’s office for signatures.
10. Facilitates any and all medical record documents necessary to complete upload to document imaging system.
11. Performs quantity and quality checks on scanned medical record information as part of the Quality Control (QC) function.
12. Responsible for document imaging equipment maintenance prior to shift/use and maintains equipment cleaning and supplies.
13. Logs deficiencies of charts on Deficiency log and assists doctors with compliance.
14. Process anesthesia records – scan and email to billing companies.
15. Serves as an information resource by responding to requests for general and medical record information received via phone, email, fax, or in person.
16. Assist physicians with the completion of deficient medical record information.
17. Travels offsite to obtain old medical records and to physician offices for chart completion purposes.
18. Maintains a good working relationship with inter-departmental personnel as well as with other department and physicians within the hospital.
19. Obtains patient medical information from floors upon patient discharge and reconciles and tracks records.
20. Manually checks in all incoming and outgoing medical records for chart tracking.
21. Handles records retrieved from off-site storage (retrieved and returned).
22. Moves medical records for expansion as required (destruction) and signs off on destruction record.
23. Complies with hospital, Medical Records Departmental Policies and Procedures, State, and Federal statute (HIPAA) regarding release of protected health information, confidentiality, and patient rights.
24. Prepares incoming correspondence for processing, opens and date stamps mail, and verifies the completeness and HIPAA compliance of the patient authorization.
25. Maintains a correspondence log of all patient information that has been released.

26.  Attends and participates in department staff meetings and in-service trainings as  directed.
27. Maintains confidentiality. At all times, displays positive customer relations skills.
28. Responds appropriately to hospital emergency procedures.
29. Performs clerical tasks and all other duties as required to meet the needs of the Health Information and Informatics Management department.