Medical Records Specialist

3 weeks ago


Fayetteville, North Carolina, United States A Brighter Future Healthcare Services Full time
Job Title

Medical Records Specialist - Chart Accuracy and Compliance

About A Brighter Future Healthcare Services:

We are a leading provider of comprehensive healthcare services dedicated to delivering high-quality care to our community. Our family medical practice is committed to patient-centered care and strives to maintain the highest standards of medical record accuracy and integrity.

Estimated Salary:$52,000 per year

Position Overview:

The Medical Records Specialist ensures the accuracy, completeness, and compliance of medical records within our family medical practice. This role involves auditing patient charts, managing electronic health records (EHR), and ensuring all scanned documents are correctly filed and indexed.

Key Responsibilities:

  • Chart Auditing: Review patient charts to ensure accuracy, completeness, and compliance with regulatory standards and practice guidelines. Identify discrepancies or missing information and take corrective action.
  • Record Management: Organize, maintain, and update electronic health records (EHR) in a timely and accurate manner. Ensure all patient information is correctly recorded and easily accessible.
  • Document Scanning: Scan and upload patient documents, including medical records, test results, and other relevant paperwork into the EHR system. Ensure all scanned documents are clear, legible, and correctly indexed.
  • Compliance: Ensure all records and documentation practices comply with HIPAA regulations and other relevant healthcare laws and standards. Participate in internal audits and implement corrective actions as needed.
  • Collaboration: Work closely with physicians, nurses, and administrative staff to ensure patient records are accurate and up-to-date. Provide training and support to staff on record-keeping and compliance procedures as needed.
  • Quality Assurance: Conduct regular quality checks on medical records and scanned documents to maintain high standards of accuracy and completeness. Report any issues or concerns to the Medical Records Supervisor.
  • Reporting: Generate and maintain reports on chart audits, compliance issues, and other relevant data. Provide insights and recommendations to improve record-keeping processes and practices.

Qualifications:

  • Education: High school diploma or equivalent required; Associate's degree in Health Information Management or related field preferred.
  • Experience: Minimum of 1-2 years of experience in medical records chart auditing or a related field within a healthcare setting. Experience with EHR systems is highly desirable.
  • Skills:
    • Strong attention to detail and organizational skills.
    • Proficiency in using EHR systems and Microsoft Office Suite.
    • Knowledge of medical terminology and healthcare regulations, including HIPAA.
    • Ability to work independently and as part of a team.
    • Excellent communication and interpersonal skills.
  • Certifications: Certification as a Registered Health Information Technician (RHIT) or Certified Medical Records Technician (CMRT) is a plus.

Working Conditions:This position typically operates in a medical office environment. The role may involve prolonged periods of sitting and using office equipment, including computers and scanners. Occasional lifting of files or paper is required.



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