Job Description
POSITION PURPOSE: The Medical Scribe is responsible for providing real-time, accurate medical documentation and support to physicians. The Scribe will play an integral role in ensuring that we maintain high standards of patient care by providing timely and accurate documentation to support medical decision making. The ideal candidate will have exceptional writing skills, excellent medical terminology knowledge and be able to work in a fast- paced environment. The candidate will work closely with the physicians to document patient history, physical exams, and procedures in the electronic health record (EHR). The Scribe will also be responsible for other clerical tasks, such as preparing patient charts and retrieving lab results.
POSITION REQUIREMENTS / QUALIFICATIONS: Education/Experience: High School Diploma or Equivalent required. College sophomore or higher preferred, preferably with a pre-med or nursing major. Prior experience working in Ob/Gyn, Cardiology office a plus.
Licensure / Certification: CPR-BLS required.
Skills / Attributes: Strong computer skills and proficiency using an electronic medical record desired. Excellent organizational and time management skills with a strong attention to detail. Strong understanding of medical vocabulary, abbreviations and terminology. Have a patient and compassionate demeanor. Excellent oral and written communication skills.
POSITION RESPONSIBILITIES • Assist healthcare professionals in documenting patient encounters accurately and efficiently
• Enter patient information into the electronic health record system
• Help maintain accurate patient medical history and update records as needed
• Maintain confidentiality of patient records and information
• Timely and accurately complete EHR entries following each patient encounter
• Provide real time support to physicians
• Order and track lab results
• Order and track diagnostic services
• Order and track referrals
• Enters patient room with the physician during patient visit to capture and transcribe medical record documentation utilizing the EHR
• Updates patient history, physical exam and other pertinent health information in the patient's chart
• Participates in selected meetings
• Demonstrates appropriate understanding of the cultural diversity in the community and patient population.
• Able to adhere and comply with CHI's culture to ensure that the patient is well cared for
• Adhere to department Policies and Procedures in performing duties and assignments.
• Demonstrates the ability to work with a diverse population.
• Reports to work on time and ready to work with minimal absenteeism
• Adheres to Confidentiality Policies and Procedures / HIPAA Regulations.
• Performs other duties as assigned.
• Must be able to travel with OB/GYN physician to various sites.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
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