Job Summary: 

• Accompany the physician to medical exams and report in writing the patient's history, medications, physical examination, and patient orders that result from the visit.
• Record the results of ordered tests once returned by the lab.
• Complete the chart by writing the discharge and follow-up instructions.
• Verify the chart for the appropriate coding level.
• Review the chart and ensure it has been documented correctly for the designated code.
• Ensure the physician reviews the chart for accuracy.
• Obtain the physician's signature for each encounter.
• Relay messages to the nursing staff, medical technicians, and/or the patient to expedite patient flow throughout the department.

Skills on Resume: 

• Clinical Documentation (Hard Skills)
• Test Result Logging (Hard Skills)
• Chart Completion (Hard Skills)
• Medical Coding Review (Hard Skills)
• Accuracy Verification (Soft Skills)
• Physician Coordination (Soft Skills)
• Signature Management (Hard Skills)
• Patient Flow Communication (Soft Skills)

Job Summary: 

• Perform real-time documentation of a physician’s clinical visit with high accuracy.
• Record the patient’s medical history.
• Transcribe the physician’s physical examination.
• Record diagnostic results such as radiology interpretations and lab values.
• Organize plan and patient instructions.
• Accurately search and locate an ICD-10 diagnosis as directed by the physician.
• Issue physical therapy orders, home exercises, educational handouts, work restrictions, and other orders per the physician's instruction.
• Electronically fax completed office visit note to the referring physician for continuity of care.
• Work with the physician staff to ensure quality patient care and services are provided.
• Ensure compliance with clinic standards of quality patient care.
• Maintain all information in the strictest confidentiality.

Skills on Resume: 

• Real-Time Documentation (Hard Skills)
• Medical History Recording (Hard Skills)
• Exam Transcription (Hard Skills)
• Diagnostic Data Entry (Hard Skills)
• ICD-10 Lookup (Hard Skills)
• Order Processing (Hard Skills)
• Team Collaboration (Soft Skills)
• Confidentiality Compliance (Soft Skills)

Job Summary: 

• Assist the medical provider in being more efficient and productive.
• Enter data into the patient’s electronic record, scan and index documents accurately into the patient’s electronic medical records.
• Take patient histories and vital signs.
• Transcribe the patient’s history and physical exam.
• Document consultations.
• Take responsibility for greeting patients.
• Schedule appointments.
• Assist patients with ambulation, transfer to and from the exam table.

Skills on Resume: 

• Efficiency Support (Soft Skills)
• EMR Entry (Hard Skills)
• History Intake (Hard Skills)
• Vital Collection (Hard Skills)
• Exam Transcription (Hard Skills)
• Consult Documentation (Hard Skills)
• Appointment Scheduling (Hard Skills)
• Patient Assistance (Soft Skills)

Job Summary: 

• Provide excellent customer service to patients by listening and appropriately serving patients in support of the Shoulder/Knee Surgeon.
• Relay relevant information to the appropriate internal staff.
• Assist the provider in navigating the Electronic Health Record (EHR) system.
• Enter information into EHR as directed by the provider.
• Research information as requested by the provider.
• Respond to various messages as directed by the provider.
• Assist the physician/physician assistant with documenting patient care in the EHR and ensuring that all services ordered are coded in the EHR and on the patient's superbill.
• Participate in office meetings and educational activities.
• Comply with HIPAA procedures.

Skills on Resume: 

• Customer Service (Soft Skills)
• Info Relay (Soft Skills)
• EHR Navigation (Hard Skills)
• EHR Data Entry (Hard Skills)
• Info Research (Hard Skills)
• Message Response (Soft Skills)
• Care Documentation (Hard Skills)
• HIPAA Compliance (Hard Skills)

Job Summary: 

• Accompany the provider during the patient examination.
• Accurately and thoroughly document pertinent patient information as instructed by the provider.
• Record details of chief complaint, history of present illness, review of systems, social history, past medical history, family medical history, allergies, medications, problems and diagnoses, history and physical, and any pertinent positive and negative findings.
• Propose orders in the EHR based on the clinical setting.
• Document details of procedures and treatments, laboratory test results, radiology test results, and assist with documenting radiographic impressions performed by the provider.
• Assist with verifying all tests, such as lab, X-ray, and EKG, have been completed and the results have been received, reviewed, and recorded in the medical record.
• Select patient education leaflets from the EHR as instructed by the provider.
• Assist in preparing paperwork for patient discharge.
• Maintain confidentiality of all patient information.
• Work under the direction of Physicians or independent licensed practitioners, providing documentation assistance.

Skills on Resume: 

• Exam Assistance (Soft Skills)
• Patient Documentation (Hard Skills)
• Comprehensive Recording (Hard Skills)
• EHR Order Proposal (Hard Skills)
• Procedure Documentation (Hard Skills)
• Test Verification (Hard Skills)
• Patient Education (Hard Skills)
• Discharge Prep (Hard Skills)

Job Summary: 

• Accompany the physician and/or mid-level provider into the patient examination area in order to transcribe findings in real time as the provider evaluates the patient.
• Document the history of the patient’s chief complaint as given by the patient and communicated by the provider.
• Document the physical examination as given by the patient and communicated by the provider.
• Transcribe, under the direction of the provider, patient orders including laboratory tests, imaging tests, and medication orders.
• Look up pertinent past medical records at the direction of the provider.
• Keep track of and enter the results of imaging and lab studies as directed by the provider.
• List proper diagnosis and discharge or follow-up instructions and prescriptions as dictated by the provider.
• Enter the level of service for the designated code assigned by the provider.
• Assure that the EHR is complete and all pertinent documentation requirements are met.
• Retrieve completed lab results.
• Complete occasional prior authorizations.
• Be involved in special projects.
• Provide some patient education, such as inhaler technique and EpiPen techniques.
• Create letters and forms for patients and providers.

Skills on Resume: 

• Real-Time Transcription (Hard Skills)
• History Documentation (Hard Skills)
• Exam Documentation (Hard Skills)
• Order Transcription (Hard Skills)
• Record Retrieval (Hard Skills)
• Result Entry (Hard Skills)
• Diagnosis & Instructions (Hard Skills)
• EHR Completion (Hard Skills)

Job Summary: 

• Perform patient intake, showing above-average grammar, punctuation, and spelling.
• Complete treatment plans and assessments for all assigned patients.
• Collect urine samples and complete lab requisition requirements.
• Prepare and restock the procedure room and forms in exam rooms.
• Assist with procedures.
• Prepare orders such as MRIs, referrals, physical therapy, etc.
• Assist the physician with all E-prescriptions and the setup of electronic prescriptions being submitted.
• Complete charge-outs and bill-outs.
• Dispense DME and collect acknowledgment forms from patients.
• Follow up with medical providers regarding pending documentation.
• Assist the provider in completing any patient forms that are necessary, such as DWC, etc.
• Maintain a clean procedure room and patient examination rooms.
• Communicate with the Authorizations Department regarding add-on procedures.
• Scan and upload patient documentation, such as prescriptions, medical records, DME forms, etc.
• Review messages and tasks daily and resolve or delegate on demand.
• Prepare weekly for the upcoming clinics.

Skills on Resume: 

• Intake Documentation (Hard Skills)
• Treatment Planning (Hard Skills)
• Lab Collection (Hard Skills)
• Room Preparation (Hard Skills)
• Procedure Assistance (Hard Skills)
• Order Preparation (Hard Skills)
• E-Prescription Support (Hard Skills)
• Message Management (Soft Skills)

Job Summary: 

• Document the physician dictated patient history, including history of present illness, review of systems, past medical and surgical history, family and social histories, medications, allergies, and dictated physical exam findings, without interjecting their own observations.
• Document procedures performed by the provider.
• Import radiology reports, lab results, procedure results, as well as progress notes from other providers.
• List all proper diagnoses and symptoms, as well as follow-up instructions and prescriptions as dictated by the physician.
• Transcribe patient orders, including laboratory tests, radiology tests, medications, etc.
• Establish and maintain effective working relationships with physicians, staff, and management.
• Facilitate communication between providers and other staff.
• Travel to different clinic locations throughout the area.
• Perform other clerical tasks that optimize efficiency.

Skills on Resume: 

• History Documentation (Hard Skills)
• Procedure Documentation (Hard Skills)
• Record Importing (Hard Skills)
• Diagnosis Listing (Hard Skills)
• Order Transcription (Hard Skills)
• Team Collaboration (Soft Skills)
• Staff Communication (Soft Skills)
• Clinic Travel Support (Soft Skills)

Job Summary: 

• Assist the provider by documenting the provider-patient encounter during the patient exam exactly as it is verbalized.
• Accompany the provider into the patient examination room to document the provider's encounter with the patient.
• List all proper diagnoses and symptoms, as well as follow-up instructions and prescriptions as indicated by the provider.
• Transcribe patient orders, including laboratory tests, radiology tests, and medications.
• Document procedures performed by the provider.
• Ensure timely application of dictated material to patients' records.

Skills on Resume: 

• Encounter Documentation (Hard Skills)
• Exam Assistance (Soft Skills)
• Diagnosis Listing (Hard Skills)
• Order Transcription (Hard Skills)
• Procedure Documentation (Hard Skills)
• Record Updating (Hard Skills)
• Provider Support (Soft Skills)
• Timely Entry (Hard Skills)

Job Summary: 

• Offer one-on-one time with physicians and other healthcare providers.
• Gain exposure to an emergency or outpatient environment.
• Observe a wide variety of cases from trauma to pediatrics to the elderly.
• Develop lasting relationships with partnering physicians, with the potential for letters of recommendation.
• Transcribe chart notes in real time from physicians and advanced-level providers, including documenting HPI, past medical, family and social history, ROS, physical exam, diagnostic studies and interpretations, responses to medications and treatments, procedures, re-evaluation, and consultations.
• Type correspondence and special reports.

Skills on Resume: 

• Provider Exposure (Soft Skills)
• Clinical Observation (Soft Skills)
• Case Exposure (Soft Skills)
• Professional Networking (Soft Skills)
• Real-Time Transcription (Hard Skills)
• Comprehensive Charting (Hard Skills)
• Report Typing (Hard Skills)
• Documentation Support (Hard Skills)

Job Summary: 

• Maintain an environment of safety for patients, yourself, and others.
• Enter data into the electronic medical record, ensuring the EMR is complete and accurate.
• Gather and document clinical information from other current or historical records under the direction of the provider.
• Perform other duties that improve the efficiency of the provider, such as assisting with medication reconciliation, documenting procedures, and providing communication assistance (message to other providers, scanning, printing, or copying medical records).
• Complete annual HIPAA, patient confidentiality, and scribe training requirements and sign a confidentiality agreement.
• Educate patients on recommended procedures or medications.

Skills on Resume: 

• Safety Maintenance (Soft Skills)
• EMR Data Entry (Hard Skills)
• Record Gathering (Hard Skills)
• Provider Efficiency Support (Soft Skills)
• Procedure Documentation (Hard Skills)
• Communication Assistance (Soft Skills)
• HIPAA Compliance (Hard Skills)
• Patient Education (Soft Skills)

Job Summary: 

• Prepare patients for treatments.
• Educate patients on treatment plans.
• Provide pre-care treatment instructions.
• Assist with dermatological procedures and cosmetic treatments.
• Assist in nursing procedures, including suture removal.
• Handle medical instrument cleaning and sterilization.
• Maintain exam rooms.

Skills on Resume: 

• Patient Preparation (Hard Skills)
• Patient Education (Soft Skills)
• Pre-Care Instruction (Soft Skills)
• Procedure Assistance (Hard Skills)
• Suture Support (Hard Skills)
• Instrument Sterilization (Hard Skills)
• Room Maintenance (Hard Skills)
• Treatment Support (Hard Skills)

Job Summary: 

• Transcribe physician examinations of patients' appointments - be the caretaker of patients' office visit records.
• Upload notes into EHR.
• Record into the patient record the correct ICD-10 diagnosis codes.
• Manage patient records, including the appropriate degree of medical decision making and time spent with the patient, are recorded.
• Communicate with the Billing Department to make sure appointment records are properly conveyed.
• Follow up with patients, referring physicians, workers' compensation case managers, and others in the management of patients' healthcare records.

Skills on Resume: 

• Exam Transcription (Hard Skills)
• EHR Uploading (Hard Skills)
• ICD-10 Coding (Hard Skills)
• Record Management (Hard Skills)
• Billing Coordination (Soft Skills)
• Patient Follow-Up (Soft Skills)
• Provider Communication (Soft Skills)
• Healthcare Records Support (Hard Skills)

Job Summary: 

• Gather information for patient visits and partner with physicians to deliver effective patient care.
• Enter the documentation of a provider encounter in an accurate and detailed manner.
• Enter all documentation on time.
• Comprehend provider documentation that may be handwritten, verbal, or electronic.
• Enter other data into the electronic medical record (EHR), as directed by the Provider.
• Assist the provider in navigating electronic medical record (EHR) responses to messages.

Skills on Resume: 

• Patient Info Gathering (Hard Skills)
• Care Support (Soft Skills)
• Accurate Documentation (Hard Skills)
• Timely Entry (Hard Skills)
• Note Comprehension (Hard Skills)
• EHR Data Entry (Hard Skills)
• EHR Navigation (Hard Skills)
• Message Support (Soft Skills)

Job Summary: 

• Anticipate the physician needs to facilitate the flow of clinic business, while exercising a high degree of discretion, tact, and humility in the performance of duties so as not to distract medical staff from patient care.
• Accurately and thoroughly document medical visits, procedures, and treatments as they are being performed by the physician in the exam room.
• Apply significant attention to detail in order to spot mistakes and to ensure that all clinical data, lab or other test results are without inconsistencies and are recorded accurately in the medical record.
• Comply with specific standards, laws, and ethical rules that apply to the style of medical charting.
• Prepare referral letters as directed by the physician, via dictation or summary of the medical record, which often includes the generation of electronic orders for prescriptions, durable medical equipment (DME), diagnostic exams, surgeries, physical therapy, and occupational therapy.
• Collect, organize, and catalog data for the physician quality reporting system and other quality improvement efforts in a format suitable for submission.

Skills on Resume: 

• Physician Anticipation (Soft Skills)
• Real-Time Documentation (Hard Skills)
• Detail Accuracy (Hard Skills)
• Charting Compliance (Hard Skills)
• Referral Preparation (Hard Skills)
• Order Generation (Hard Skills)
• Data Organization (Hard Skills)
• Quality Reporting (Hard Skills)

Job Summary: 

• Review the chart to ensure previously ordered test results are available for the patient's visit.
• Document patient history and exam into an electronic medical record (EPIC).
• Work with the physician and medical assistant to ensure quality care.
• Record the patient’s chief complaint and history.
• Scribe or transcribe the physical exam.
• Record diagnostic test results.

Skills on Resume: 

• Test Review (Hard Skills)
• History Documentation (Hard Skills)
• Care Coordination (Soft Skills)
• Chief Complaint Entry (Hard Skills)
• Exam Transcription (Hard Skills)
• Diagnostic Recording (Hard Skills)
• EMR Documentation (Hard Skills)
• Physician Support (Soft Skills)

Job Summary: 

• Accurately and thoroughly document medical visits and procedures as they are being performed by the physician.
• Operate the electronic health records of patients.
• Anticipate the physician's needs to facilitate the flow of the clinic.
• Exercise discretion, tact, and modesty in the performance of duties to avoid distracting medical staff from patient care.
• Open and close exam rooms.
• Help with testing and keep rooms filled to maintain the flow of the clinic.

Skills on Resume: 

• Real-Time Documentation (Hard Skills)
• EHR Operation (Hard Skills)
• Physician Anticipation (Soft Skills)
• Professional Discretion (Soft Skills)
• Room Preparation (Hard Skills)
• Room Closing (Hard Skills)
• Testing Assistance (Hard Skills)
• Clinic Flow Support (Soft Skills)

Job Summary: 

• Follow the provider to each patient room in order to document the patients’ visits into the Electronic Medical Record (EMR) system.
• Provide ancillary clerical services to the providers, including retrieving old medical records, lab results, radiology results, making phone calls, relaying messages, and any other clerical operations that would assist the provider in his or her function.
• Provide patient comfort measures as requested and permitted.
• Adhere to mandatory Integritas and/or healthcare facility policies, as outlined in the employee handbook or facility guidelines.
• Avoid providing any clinical aide or having any patient contact.
• Participate in quarterly lunch meetings.
• Stay informed and follow the HIPAA guidelines.

Skills on Resume: 

• Room-to-Room Scribing (Hard Skills)
• Clerical Support (Hard Skills)
• Record Retrieval (Hard Skills)
• Patient Comfort (Soft Skills)
• Policy Adherence (Soft Skills)
• No Clinical Contact (Soft Skills)
• HIPAA Compliance (Hard Skills)
• Meeting Participation (Soft Skills)

Job Summary: 

• Accompany the physician into the exam room.
• Enter vital signs and keep track of lab values.
• Look up pertinent past medical records.
• Prioritize the physician's time by bringing critical lab results to his/her attention.
• Type progress notes.
• Interview patients, measure vital signs, such as pulse rate, temperature, blood pressure, weight, and height, and record information on patients' charts.
• Perform documentation in the EHR while working directly with the Physician.
• Take the patient history and input it into the EMR.
• Draw up injections.
• Remove sutures and staples.
• Hand instruments and materials to the doctor.
• Clean and sterilize instruments.
• Assemble casts for patients.
• Inventory and order medical supplies and materials.

Skills on Resume: 

• Exam Accompaniment (Soft Skills)
• Vital Tracking (Hard Skills)
• Record Lookup (Hard Skills)
• Critical Result Alerting (Soft Skills)
• Progress Note Typing (Hard Skills)
• Patient Interviewing (Soft Skills)
• EHR Documentation (Hard Skills)
• History Input (Hard Skills)

Job Summary: 

• Accurately and thoroughly document medical visits and procedures as they are being performed by the provider.
• Document the patient's medical history and physical exam.
• Document patient education and explanations of risks and benefits.
• Document provider-dictated diagnoses, prescriptions, and instructions for patient or family members for self-care and follow-up.
• Perform dictation, faxing, phone calls, and clerical tasks.
• Research contact information for referring providers, coordinate referrals, make phone calls, and perform other clerical tasks.
• Spot mistakes or inconsistencies in medical documentation and check to correct the information in order to reduce errors.
• Ensure that all addenda are signed off by a provider.
• Ensure that all clinical data, lab or other test results, and the interpretation of the results by the provider are recorded accurately in the medical record.
• Alert provider when the chart is incomplete.
• 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.
• Attend training on diverse subjects such as information technology, legal, HIPAA, and regulatory compliance.
• Quickly assimilate new knowledge into processes and procedures.
• Proofread and edit all the provider’s medical documents for accuracy, spelling, punctuation, and grammar.

Skills on Resume: 

• Real-Time Documentation (Hard Skills)
• History & Exam Entry (Hard Skills)
• Education Documentation (Hard Skills)
• Diagnosis Transcription (Hard Skills)
• Clerical Support (Soft Skills)
• Referral Coordination (Soft Skills)
• Error Spotting (Hard Skills)
• Record Accuracy Review (Hard Skills)