Job Summary:
Responsible for ensuring medical records are complete, accurate, and support the patient classifications assigned upon admission. Responsible for keeping abreast of any changes in the requirements set forth by regulatory agencies and hospital governing groups. Assigns deficiencies to be reviewed and completed by responsible physicians within specified timeframes. Serves as a knowledge base for compiling and validating incomplete records data to support physician process improvement activities for the HIM Department. Determines specific documentation types according to varied medical specialty requirements. Reviews imported data to determine appropriateness for inclusion in legal medical records and minimum data sets. Responsible for updating and maintaining the Enterprise Master Patient Index. Works collaboratively with corresponding hospital department staff members to address inconsistencies or ambiguities in medical records and report trends with workflow change suggestions to avoid recurrence. Serves as a resource for chart corrections/amendments as required by law and/or hospital policy.
Reports:
Director, HIM and/or Assistant Director, HIM
Supervises:
None
Required Education:
Associate degree in HIM or other medical office study required. Human Resources (HR) may substitute medical record experience for required education on a 1:1 basis. Experience substituted for education will not be applied toward the minimum required experience below.
Required Experience:
Two (2) years of experience in a medical office, hospital office, or department with electronic medical record aligned duties. Experience substituted for education above will not be applied toward the minimum required experience.
Preferred: Demonstrated knowledge of electronic medical records (EMR) chart structure and technology. Knowledge of regulatory and hospital documentation requirements. Excellent verbal and written communication skills. Expertise in Microsoft Office. Strong analytical skills.
Required Certification/License/Registry:
None required. Registered Health Information Technician (RHIT) or Certified Health Data Analyst (CHDA) preferred.
If you are interested in becoming a part of TMH’s legacy of quality & compassionate healthcare, we want to know you.
Please submit your application & resume TODAY! We look forward to speaking with you.
Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen, background check, reference verification, health assessment, and credential/license verification.
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