Medical Records Specialists

Medical Records Specialists typically perform the following 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. • Maintain or operate a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information. • Post medical insurance billings. • Process and prepare business or government forms. • Process patient admission or discharge documents. • Protect the security of medical records to ensure that confidentiality is maintained. • Release information to persons or agencies according to regulations. • Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings. • Retrieve patient medical records for physicians, technicians, or other medical personnel. • Review records for completeness, accuracy, and compliance with regulations. • Scan patients' health records into electronic formats. • Schedule medical appointments for patients. • Transcribe medical reports.