Medical Scribe acts as an assistant during the examination and treatment of patients under the direction of a physician. Documents and gathers information during the treatment process. Being a Medical Scribe organizes healthcare data to provide better service and efficiency of clinical care. Typically requires an associate degree. Additionally, Medical Scribe may require certification as a Medical Scribe by the American College of Clinical Information Managers (ACCIM). Typically reports to a physician. The Medical Scribe works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Scribe typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Full-Time, Days
DHR Health
POSITION SUMMARY: The Primary role of a medical “transcribe” is to assist the physician with the complete documentation of patients’ charts. Transcribes accompany the physician as he/she examines and interviews patients and then records the physician’s observations and comments on either on paper or in an electronic medical record (EMR) depending on what the hospital uses. All information is recorded in the presence of a physician
POSITION EDUCATION/QUALIFICATIONS: •High School graduate or equivalency. •Medical Terminology or Medical Assistance certification preferred. •Two (2) years experience in an MD office preferred. •Excellent customer service skills. •Computer skills required with knowledge of Microsoft Office suite. •Good written and verbal communication skills required. •Bilingual – English/Spanish.
POSITION RESPONSIBILITIES: •Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices •Keep track of laboratory tests, medications, and radiology tests ordered by the physician •Gather data for physician review (i.e., laboratory results, faxed radiology reports, medical records) •Coordinate communication between physicians and staff, make and answer telephone calls •Document any consultations the ED physician makes to a patient’s personal doctor, family members, or on-call physician. •Provide patients with updates about waits and delays •Document all procedures done by the physician. Procedures may include life performing support, reducing dislocations, suturing, etc. •Responsible for documenting all diagnoses, treatment plans, prescriptions, and discharge/follow-up information for each patient. •Other duties as assigned.
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