Medical Scribe-OSNC

Overview

Tri-City Healthcare District has been serving the North County region for almost 60 years and remains committed to providing high quality healthcare and community services for every individual we encounter regardless of race, color, ethnicity, gender, sexual orientation, disability or socioeconomic status.

Our mission is to advance the health and wellness of the community we serve. In order to achieve our mission, we see, hear and listen to our front line healthcare workers, employees, medical staff and all community stakeholders in order to understand and meet our community’s needs.

Position Summary :

The medical scribe works to facilitate patient flow and ensure an accurate and complete medical record for each patient. The Medical Scribe assists the medical provider by accompanying them during the medical history-taking and exam, recording details of both into the medical record.

Major Position Responsibilities :

The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

Maintains a safe, clean working environment, including unit based safety and infection control requirements. Administrative Maintains a clean and organized work area. Maintains working knowledge of orthopedic medical terminology and accepted abbreviations. Understands and recognizes the physical exam process and has the ability to record exam details. Computer proficient and able to quickly learn new applications. Tracks patient care and improves patient flow. Demonstrates a professional demeanor and recognizes privacy considerations for patients and families. Displays flexibility in scheduling. Calmly copes with a high pressure environment. Clinical Records details of chief complaint, history of present illness, review of systems, past medical history, social history, family medical history, disease risk factors, medications and allergies. Records details of physician exam, including pertinent positives and negatives, noted abnormalities and patient general condition. Submits orders as desired by medical provider and checks constantly for results of those orders.

Qualifications:

Six months of Medical Scribe experience or related clinical training, required. Strong medical terminology, required. Strong writing skills, required. Computer proficiency with Windows applications, required. Ability to type a minimum of 45 WPM, required. Ability to work under stress with interruptions and deadlines. Ability to process verbal information and proceed accordingly. Ability to follow complex instructions. Ability to use basic math skills needed to write prescriptions and draw injections. Ability to think logically and critically and come to a conclusion. Ability to enter and retrieve data from a computer. Ability to use the phone system, copier, fax and printers. Ability to navigate the EHR system. Ability to communicate with a high level of medical knowledge to patients, staff, management, Physicians and others. Demonstrates a high level of medical knowledge in regards to patient care, office procedures, patient evaluation, medical terminology, OSHA regulations, etc. Knowledge of CPT, ICD-9/ICD-10, and HCPCS coding. Demonstrated awareness of the patient as an individual, with specific physical, psychological and spiritual needs. Obeys and adheres to all policies and procedures outlined in the handbook Experience with Electronic Medical Records, preferred.

Education:

High School diploma or GED, required.

Certifications:

Certified Medical Assistant, preferred.

Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.

*Salary/Hourly Wage range based on experience.

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