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Snf Medical Records Assistant

1 month ago

North Hills, United States The Rehabilitation Center of North Hills Full time

Medical Records Assistant - FT $18.00

Organize and manage health information ensuring quality, accuracy and timely accessibility of patient medical information. Process transcription reports for patient records and complete correspondence reports. Perform qualitative and quantitative chart analysis and validate admission/discharge census. Maintain security and privacy of patient records and provide support to physicians and other disciplines within the organization. Reports to Medical Records Director. Follow HIPPA / State/ Fed Regulations. ICD-10 Coding.

**KEY RESPONSIBILITIES**:

- Has experience in using a computer, Excel program and good typing skills.
- Proficient in the English language with at least a good comprehension of the English language.
- Does the accurate abstracting of patient’s information, and enters accurate discharge disposition of patients in AIS.
- Assigns/supplies correct ICD-10-CM and CPT, if asked, on all diagnoses provided in all patients’ charts.
- May be asked to supply HCPCS CODES on all procedures and services performed.
- Queries physicians to verify correct diagnosis.
- Attends seminars or webinars as required to remain current on coding issues.
- Audits medical records to ensure proper coding completed and to ensure compliance with both federal and state regulatory bodies.
- Accurately follows coding guidelines and legal requirements to ensure compliance with both federal and state regulatory bodies.
- Monitors the daily Missing Discharge DX Report from AIS.
- Makes sure that all discharged charts are coded no more than 3 days after discharged.
- Reports all cases with undetermined or missing primary diagnoses to the HIM Director.
- Coordinates and pull charts necessary for coding audits including Medicare coding audits.
- Maintains current Coding certification if any.
- Works well and harmoniously with the rest of the HIM Staff.
- Keeps good work ethics.
- May help in gathering discharge charts when asked.
- May answer incoming calls when asked.
- Maintains punctual work attendance and has flexibility in schedule and may be asked to flex when there are few charts to code.
- Maintains confidentiality of her/his assigned ASR’s system username and password.
- Adheres to HIPAA law.
- **POSITION REQUIREMENTS**:

- One year of experience working with medical records preferred.
- Coursework specific to regulations pertaining to the proper administration of medical records preferred.
- Demonstrated knowledge of patient's privacy relative to maintaining medical records required.
- Familiarity with medical terminology preferred.

**Experience**:

- Medical Records: 1 year (required)
- Education:

- High school or equivalent (required)

Pay: $18.00 - $18.01 per year

Schedule:

- Monday to Friday

**Education**:

- High school or equivalent (preferred)

**Experience**:

- Medical Records: 1 year (preferred)
- ICD coding: 1 year (preferred)
- SNF: 1 year (preferred)

Work Location: In person

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