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Medical Document Specialist
2 weeks ago
Medical professionals play a vital role in the healthcare system by ensuring accurate and timely documentation of patient information.
Key Responsibilities- Review physician dictation and transcribe clinical notes into electronic medical records and billing systems.
- Prepare and assemble medical record documentation/charts for physicians, ensuring compliance with regulatory requirements.
- Update patient history, physical exam, and other pertinent health information in the patient's chart.
- Monitor duration of basic lab results and screening procedures, communicating with clinical staff as necessary.
- 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, ensuring accurate and sequenced coding in accordance with government regulations.
- 3-5 years of experience in medical documentation or a related field.
- Administrative writing skills, including attention to detail and ability to maintain confidentiality.
- Strong organizational and time management skills, with ability to prioritize tasks and meet deadlines.
- Proficiency in Microsoft Office applications, including Word, Excel, and Outlook.
- Excellent communication and interpersonal skills, with ability to work effectively with healthcare providers and support staff.
