Medical Scribe

The Cardiac and Vascular Institute
of Gainesville, FL is seeking
MEDICAL SCRIBES
for our cardiology practice. These are part-time positions with variable hours. Prior scribe experience or formal education in medical terminology, anatomy, physiology or other related coursework is required.

The primary goal of a Medical Scribe is to increase the efficiency and the productivity of the physician they are working for. The Medical Scribe allows the doctor to focus on what is most important, the patient.

Medical Scribes perform clerical and information technology functions for a physician in a clinic setting. This includes primary responsibility of the operation of the electronic health records and electronic dictation system. Medical Scribes must be discreet, tactful, and modest in performance of duties so as not to distract medical staff from patient care. Good judgment, organizational ability, initiative, attention to detail, and the ability to be self‑motivated are especially important when working as a Medical Scribe.

You must be adaptable and versatile since you will be responsible for many tasks. Good attendance is also an important element of this job.

Full day(s) of availability needed. We are open Monday - Friday.

Some of the more detailed job duties and responsibilities of a Medical Scribe are:

1. Accurately and thoroughly
document medical visits and procedures
as they are being performed by the physician, including but not limited to:

• Patient medical history and physical exam,
• Procedures and treatments performed by healthcare professionals, including nurses and physician assistants.
• Patient education and explanations of risks and benefits.
• Physician‑dictated diagnoses, prescriptions and instructions for patient or family members for self‑care and follow‑up
• Prepare referral letters as directed by the physician

2. Medical Scribes also
spot inconsistencies in medical documentation
and check to correct the information in order to reduce errors. All addenda must be signed off by a physician. Medical Scribes ensure that all clinical data, lab or other test results, the interpretation of the results by the physician are recorded accurately in the medical record. Alert physician when chart is incomplete. Medical Scribes must comply with specific standards that apply to the style of medical records and to the legal and ethical requirements for preparing medical documents and for keeping patient information confidential.

3. Medical Scribes c
ollect, organize and catalog data for physician quality reporting system
and other quality improvement efforts and format for submission. You will assist in developing and maintaining systems to track patient follow up and compliance.

4. Attend trainings on diverse subjects such as
information technology, legal, HIPAA and regulatory compliance, billing and coding.Quickly assimilate new knowledge into processes and procedures. Medical Scribes proofread and edit all the physician’s medical documents for accuracy, spelling, punctuation, and grammar.

5. Other duties as assigned.

Education beyond a high school degree is required. Familiarity with medical and clinical terms and processes is required. Certification, Associates or Bachelor degree in medical related field is desired.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.
Language Skills
– The ability to write routine reports and correspondence. Medical Scribes must be proficient in typing and good at spelling, punctuation, grammar, and oral communication. Must be able to listen to complex medical information and summarize in a clear, complete, and concise fashion. Excellent English composition skills required to generate professional, polished writing at a high rate of production. Handwriting must be clear and legible.

2. Understanding of medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and…