STGi is seeking a Medical Records Technician to provide services to our Georgia Ware Veterans Home. 

 

JOB SUMMARY:

The primary purpose of this position is to maintain resident medical records and health information systems in accordance with current federal and state guidelines and established privacy policies and procedures.

 

ESSENTIAL FUNCTIONS:   Ensure medical records are properly completed, assembled, coded, signed, indexed, etc., before filing Assure that medical records taken from the department are signed out and signed back in upon return to the department. Batch resident information into the computer and retrieve resident demographic information as appropriate or as instructed. Ensure that new veteran admission have the necessary medical record and appropriate forms for each discipline use prior to the arrival of the new admission. Audit and review electronic health record (EHR) documentation for accuracy and completion. Maintain medical health records in a manner that is consistent with administrative, legal and regulatory requirements and best practices. Complete medical record and documentation competencies as directed. Return incomplete records/charts to appropriate departments or personnel for correction. Facilitate the transportation, retrieval, and delivery of medical records from nursing units, chart racks, therapy or other facility designated locations while safeguarding protected health information (PHI). File or input information into resident charts as requested. Fulfill authorized medical records releases (hard copy and electronic) as directed by facility policies in accordance with verified court-ordered request, legal request or as requested by appropriate and lawful means. Type and file Health and Physical Assessments of all new admissions within 30 days of admission.