ABOUT SHERIDAN MEMORIAL HOSPITAL
Sheridan Memorial Hospital is a progressive, state-of-the-art facility nestled beneath the Big Horn Mountains in beautiful Northeast Wyoming. Founded over 100 years ago, Sheridan Memorial is licensed for 88 beds with over 60 physicians who provide primary medical care and specialty care in more than 15 areas. We are proud of our more than 700 employees who provide personalized, patient-centered care in a healing environment. When people think of excellent healthcare, they think of Sheridan.JOB SUMMARY
Abstracts information from the record on each inpatient, outpatient and Emergency Department visit into the computerized medical record database. Ensures accuracy and integrity of medical record abstract data prior to billing interface. Maintains statistical information for all hospital departments.ESSENTIAL DUTIES/RESPONSIBILITIES
- Must be familiar with the following on line manuals: Administration, HIPAA, Compliance Emergency Preparedness and Safety and Hospital handbook on birth and stillbirth registration.
- Maintains hospital requirements, policies and standards on confidentiality.
- Willingly accepts additional assignments.
- Maintains a good working relationship within the department and other departments.
- Checks paper charts in and out from the department using Keane and EMR.
- Demonstrates knowledge of the EMR.
- Must be able to keep up with workload.
- Assists in employee training and orientation.
- Responds promptly and investigates thoroughly any lost or hard to find paper medical record.
- Corrects incorrectly scanned records and alerts appropriate personnel of incorrect documentation.
- Oversees that the department is kept in a neat and orderly manner including all file and storage areas.
- Deals with a wide variety of personalities in a professional and tactful manner.
- Communicates regularly with the Health Information and Records Manager, Processing Supervisor and Coding Supervisor regarding any departmental problems, issues or concerns.
- Completes in-service/on line testing on confidentiality.
- Assists in special projects.
- Ability to research archived records in card files and to be able to locate those records that do not utilize current medical record numbers.
- Responsible for coordinating the release of medical information to all requesters, including patient, healthcare providers and insurance companies and legal representatives. Maintains security and confidentiality regulations for record access and review.
- Responsible for processing of subpoenas and court orders.
- Verifies authorizations/performs duties in accordance with hospital policy and procedures and State and Federal laws.
- All requests for records are stamped with date received and entered into the EMR.
- Notifies requester when records are available.
- Consults Manager or supervisor of any unusual request.
- Responsible for scheduling appointments for review of medical records by attorney, patients, etc.
- Processes scanned and loose records daily.
- Greets walk-in customers and processes their release of information requests.
- Receives sorts and distributes all departmental correspondence to appropriate personnel and physicians on a daily basis, including faxes.
- Maintains supply closet and orders supplies as necessary.
- Analyzes all electronic records according to chart requirements.
- Must process correct and legible birth certificate within 24 hours of patient dismissal; review for accuracy and completion, with 5% or less error rate.
- Files certificates with State registrar within 10 days of completion.
- Secures all necessary signatures for proper filing of birth certificates with local and state agencies.
- Assists parent(s) of children born in the hospital by completing any forms or statements needed to correct errors on the original birth certificates.
- Maintains 100% accuracy of the birth log by accurately recording all deliveries.
- Maintains and prepares monthly birth statistics and submits to Women’s Health.
- Assemble, pull and prepares paper medical records for performance improvement studies and service committees within time specified.
- Is familiar with all types of patient charting requirements such as: pediatric, psychiatric, obstetric, newborn and surgical entering chart requirements as appropriate.
- Collects all discharged and loose patient charts from the patient care units on a daily basis.
- Analyzes medical records of discharged patients for completeness and accuracy according to department and hospital policy and procedures.
- Enters deficiencies into EMR for physician completion.
- Verification of electronic admits orders on new inpatient and OBS admits.
- Assists with auditing of patient records.
- Pulls paper charts when requested by floors.
- Proper utilization of the abstract and missing diagnosis reports.
- Process and mail doctor signature requirements for physicians that do not have EMR.
- Correcting and reissuing of double MR numbers in Keane and EMR.
- Assures the completion of doctor signature folders for paper records.
- Prepares appropriate medical records for state archives by thinning of charts, making file labels and appropriately storing records based upon the hospital’s policies and procedures and Wyoming State statute retention schedule.
- Actively participates in performance improvement and continuous Process Improvement activities.
Disclaimer: The above description has been designed to indicate the general nature of work performed within this position.MINIMUM QUALIFICATIONS
Education / Experience / License and Certifications
- High school diploma or general equivalency diploma (GED), required.
- Medical terminology desirable.
- Anatomy/physiology desirable.
- Excellent written and oral communication skills, including English usage, grammar, punctuation and style.
- Ability to operate designated equipment as specified including computer keyboarding.
- Basic clerical training, including basic filing and EMR indexing procedures (both numerically and alphabetically).
- Ability to work under pressure with time constraints.
- Excellent eye, hand and auditory coordination.
- Basic knowledge of medical record content and sequence.
- Ability to function independently with minimal direction.
- Trainee is acceptable provided the individual meets the established work standards within 8 weeks of completion of the mandatory training program for this job.
Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to age, race, color, religion, sex, national origin, disability or protected veteran status. If you’d like more information about your EEO rights as an applicant under the law, please click here.
Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.
Pre-employment drug and alcohol screening is required.