Medical Records Clerk

Overview

Maintains resident medical records and health information systems in accordance with current federal and state guidelines and established policies and procedures.

At Stone Bridge Senior Living, being a caregiver is more than our business. We consider it our privilege, and we are dedicated to both the individual needs of our residents and to each other.

Here we are more than caregivers. We are family. Each Stone Bridge community becomes a close, welcoming group in which employees help each other develop skills related to their senior care careers knowing we can do more together than we could ever do alone. Employees are encouraged to become the best version of themselves to help us provide the best possible care for our residents.

We recognize and support our associates with benefits, PTO options, and employee recognition. Here, our support doesn’t clock out when you do.

• Vacation, sick time & paid time off
• Competitive Compensation
• Flexible Scheduling
• Bonus opportunities & recognition
• Up to six paid holidays per year and/or double-time opportunities

• Organizes, plans and manages the medical records department in accordance to established policies and procedures.
• Ensures resident health information is protected and not disclosed unless by permission or with established policies and procedures.
• Retrieves resident records (manually/electronically). Delivers as necessary.
• Files information such as nursing notes, assessments, progress notes, lab reports, x-ray results, correspondence, etc., either manually or electronically into resident charts.
• Collects, assembles, checks, and files resident charts.
• Ensures incomplete records/charts are returned to appropriate department or personnel for corrections.
• Ensures resident records are properly completed, assembled, coded, etc., before filing.
• Extracts information from records for insurance companies, Medicare, Medicaid, VA, etc., in accordance to established policies and procedures and privacy rules.
• Picks up and delivers medical records to designated areas as necessary.
• Answers telephone calls in regard to inquiries about medical records. Prepares written correspondence as necessary.
• Files active and inactive records as per established policies
• Completes portion of death certificates as indicated.
• Maintains logs of specific items as per established policies and procedures.
• Maintains requests for medical records forms and completes as necessary.
• Treats all residents with dignity and respect. Promotes and protects all residents’ rights.
• Establishes a culture of compliance by adhering to all facility policies and procedures. Complies with standards of business conduct, and state/federal regulations and guidelines.
• Follows appropriate safety and hygiene measures at all times to protect residents and themselves.
• Maintains confidentiality of protected health information, including verbal, written, and electronic communications.
• Reports noncompliance with policies, procedures, regulations, or breaches in confidentiality to appropriate personnel. Reports any retaliation or discrimination to HR or compliance officer.
• Reports any allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to supervisor and/or administrator. Protects residents from abuse and cooperates with all investigations.
• Reports any occupational exposures to blood, body fluids, infectious materials, and/or hazardous chemicals in accordance with facility policy.
• Participates in all life safety and emergency drills and trainings. Fulfills responsibilities as assigned during implementation or activation of the facility’s emergency plan.
• Reports work-related injuries and illnesses immediately to supervisor.
• Follows established infection control policies and procedures.

• High school diploma or equivalent
• Minimum of 2 years’ administrative experience preferred.
• Working knowledge of medical terminology, anatomy and physiology, coding, and other aspects of health information preferred, but not required.
• Ability to read, write, speak and understand the English language.
• M…