Assessment Template For Medical Records Specialists
Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the healthcare system. Classify medical and healthcare concepts, including diagnosis, procedures, medical services, and equipment, into the healthcare industry's numerical coding system. Includes medical coders.
Medical Records Specialists
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Test Used
14607 times
Popular Job Roles
CoderHealth Information ClerkHealth Information SpecialistHealth Information Technician (Health Information Tech)Medical Records ClerkMedical Records CoordinatorMedical Records Technician (Medical Records Tech)Registered Health Information Technician (RHIT)
Occupation-Specific
Technology Skills
Medical software
Questions30
Time Limit20 min
Tasks
- Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.
- Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
- Consult classification manuals to locate information about disease processes.
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.
- Identify, compile, abstract, and code patient data, using standard classification systems.
Technology Skills
Medical software
Epic Systems, Healthcare common procedure coding system HCPCS, Henry Schein Dentrix, Medical condition coding software
Desktop communications software
Eko
Data base user interface and query software
Encoded archival system EAD, Microsoft Access, Microsoft SQL Server, Structured query language SQL
Document management software
Hyland Software OnBase, IDX Systems Patient Chart Tracking, SoftMed ChartLocater, SoftMed ChartReserve
Categorization or classification software
3M Encoder, American Medical Association CodeManager, Computerized indexing systems, DRG grouping software
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