Medical Scribe - East Boston Neighborhood Health Center Corporation

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Time Type:

Department:

All Locations:

Description:

The position of the medical scribe will be in the department of Family Medicine at South End Community Health Center site location and work under the direction of a physician. The goal of the position is to enhance the efficiency and improve the flow of patients while maintaining and improving patient satisfaction. The Medical Scribe will have the responsibility for annotating any dictated or written information for the treatment of patients following all local, state and federal guidelines for documentation into the EMR. The Medical Scribe can assist the physician with researching and recording a patient’s EMR by assembling and reviewing nurse’s notes, EMS reports, referral notes from other health care facilities, and hospital records (prior admission notes, discharge summaries, operative/procedure notes). The department of family medicine is dedicated to seeing patients of all ages by providing quality preventative care and patient centered care. South End Community Health Center has a predominantly Spanish speaking population and scribes will be expected to understand patient conversations in Spanish to transcribe information into the medical chart.

Essential Duties and Responsibilities 

• Assists the provider with documentation of each patient’s medical chart during the visit.
• Accompanies the physician in the exam room for the patient interview and examination.
• Documents the physical examination and history of the patient.
• Lists all proper diagnosis and symptoms as well as follow up instructions and prescriptions as dictated by the physician.
• Transcribes patient orders including laboratory test, radiology test, point of care testing, etc.
• Documents any procedures performed by the provider or nurses, on the electronic medical chart.
• Completes the patient’s chart by transcribing results of any labs, x-rays, or other evaluations. In doing so, the scribe continuously checks on the progress of this data in order to get the patient’s workup complete so that the provider is able to make his/her decisions regarding that patient.
• Develops expertise in the use of various templates, and documentation techniques available in the EMR, and use these tools efficiently so individual encounters are well documented, as well as accurate congregate data collected for statistical reports.
• Collaborates in weekly quality improvement meetings across the different departments
• Participates on clinical teams to support providers with paperwork and EMR inbox
• Interprets from English to Spanish for patients and providers if holding the proper certifications
• Maintains excellent punctuality and attendance.
• Writes routine reports and correspondence
• Displays outstanding customer service skills when interacting with all EBNHC customers according to the ACE model.
• Adheres to all EBNHC, SECHC, and departmental policies and procedures.
• Participates in required departmental activities and meetings.
• Performs other related duties.

EDUCATION: 

• High school diploma or GED equivalent required
• Bachelors degree or actively enrolled in bachelors program preferred
• Completion of a language assessment test provided by EBNHC

EXPERIENCE:

• Knowledge of medical terminology and descriptions
• 0-3 years working in clinical environment

SKILLS/ABILITIES:

• Verbal bilingual skills preferred.
• Ability to use electronic health record systems and Microsoft word
• Proficient in typing and good at spelling, punctuation, grammar, and oral communication.