Chief Clinical Documenter

1 day ago

Varanasi, Uttar Pradesh, India beBeeDocumentation Full time US$ 50,000 - US$ 70,000
Medical Documentation Specialist

Assist our providers with clinical documentation by transcribing physician dictation into accurate and complete clinical notes. The ideal candidate has experience using Electronic Health Records (EHR) systems and is knowledgeable about medical terminology, anatomy, and physiology.

Key Responsibilities:
  • Transcribe physician dictation into accurate and complete clinical notes in EMR/Billing systems
  • Prepare and assemble medical record documentation/charts for physicians
  • Ensure medical record compliance by self-documentation attestation
  • Update patient history, physical exam, and other pertinent health information in the patient's chart
  • Prepare and send all documentation to physicians for review and approval via authentication of detailed data entry and facility-specific procedures
  • Monitor lab results and screening procedures
  • Comply with hospital and medical facility policies, including those relating to HIPAA and Joint Commission
  • Perform other clerical duties and tasks to improve provider productivity and clinic workflow as assigned
  • Assign codes to diagnoses and procedures, using ICD and CPT codes
  • Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
Required Skills and Qualifications:
  • 3-5 years of experience as a Medical Scribe
  • Administrative writing skills
  • Reporting skills
  • Organizational skills
  • Record-keeping
  • Microsoft Office skills
  • Professionalism, confidentiality, and organization
  • Typing
  • Solid oral and written communication skills
  • Education, Experience, and Licensing Requirements:
  • Medical coding or successful completion of a certification program
  • Bachelor's degree with pre-health career track preferred
  • Strong knowledge of anatomy, physiology, and medical terminology
  • Familiarity with ICD-X codes and CPT Procedures
  • Skilled in operating various medical record software and hardware, word-processing, and database software programs

This is an exciting opportunity to work closely with healthcare professionals and contribute to the improvement of patient care. If you have excellent documentation skills and a passion for delivering exceptional service, we encourage you to apply.

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