By DeVry University
April 17, 2023
April 17, 2023
Electronic health records (EHRs) are used in healthcare settings like hospitals, medical practices, nursing homes and rehabilitation facilities where they are maintained by medical records technicians, who are skilled professionals in the health information technology field.
If you’ve been thinking about a career in the business side of healthcare, working as a medical records technician may be right for you. In this article, we will define some of the duties of medical records technicians and explore the education, skills, career outlook and certifications required to pursue this career.
Reviewing patient care documents to ensure accuracy.
Recording patient codes.
Advising on coding procedures.
Inputting and managing patient data using various software programs.
Collaborating with medical staff to clarify coding information.
According to the U.S. Centers for Medicare and Medicaid Services (CMS), EHRs are the next step toward strengthening the relationship between patients and clinicians by making patient care data more timely and more available. CMS says EHRs can reduce the incidence of medical error by improving the accuracy and clarity of health records, reduce delays in treatment and cut down on the duplication of tests. Information typically kept in EHRs includes:
Demographics
Progress notes
Medications
Vital signs
Past medical and immunization history
Laboratory and radiology data
Medical records technicians are responsible for maintaining electronic records so they are accessible for future patient visits and can be easily sent between providers when necessary. This digitization of medical records improves efficiency, cutting down on the number of times a patient is asked to provide information and potentially reducing human error that could occur in this process.
Another important aspect of health information, and a key responsibility of a medical record technician, is communicating information to the insurers or payers involved in the healthcare revenue cycle. Accurate coding is required to be sure patient conditions and treatments are documented according to insurance companies’ standard reporting systems, resulting in accurate reimbursement to providers or when billing directly to patients.
Certified Coding Associate (CCA): The CCA certification is AHIMA’s nationally recognized entry-level designation in the health information management field. Coding professionals holding this credential have demonstrated a high level of competency and professional capability. Professional experience is not required to sit for the CCA exam, but it is recommended that candidates have 6 months of coding experience or have completed an AHIMA-approved coding program or another training program that includes anatomy and physiology, medical terminology and basic CPT coding.
Certified Coding Specialist (CCS): The CCS credential verifies a coder’s skills in data quality, accuracy and coding proficiency. This credential is geared toward validating higher-level skills relevant to health information management professionals in hospitals or other healthcare settings. CCS-certified coders possess familiarity of the ICD and CPT coding systems, medical terminology, disease processes and pharmacology concepts. Recommended prerequisites for the CCS exam include a minimum of 2 years of related coding experience or holding the CCA credential plus 1 year of experience.
Registered Health Information Technician (RHIT): The RHIT is a 2-year academic program that prepares students for a career in health information management. Most RHITs work in hospitals, but they can work in a variety of other healthcare facilities. RHITs gather and analyze patient data for patient care or cost containment purposes. They often specialize in coding diagnoses and procedures in patient records for both research and reimbursement purposes. They may also function as cancer registrars, compiling and keeping data on cancer patients organized. To pursue an RHIT certification, candidates must successfully complete a health information management program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).
Certified Professional Coder (CPC): The CPC credential from AACP indicates that you have a strong understanding of how to code patient symptoms, diagnoses and diagnostic tests. Candidates must have a high-level knowledge of medical terminology, anatomy and physiology as well as procedural and supply codes.
Searching employment websites. Even if you’re not ready to join the workforce in an entry-level job, you can use their search filters to find internships.
Using your own connections. If you have a friend or family member working in a healthcare setting, ask them whether internships are available at their employer.
Attending jobs fairs. These events are a good way to see what hospitals, health systems or medical practices are hiring and to meet representatives from those organizations in person. If they don’t have an internship position open, they may keep your resume on file for consideration when you’ve completed your education and are ready to apply for an entry-level job.
Attention to detail: The very nature of medical records management demands that technicians pay attention to detail and maintain a high level of accuracy in their work.
Communication: Processing medical information may require regular interaction with medical staff or administrative professionals at healthcare facilities or insurance companies. Strong interpersonal communications skills, in verbal or written form, will enable you to effectively collaborate with these partners.
Problem-solving: When problems like denial of insurance claims arise, medical billers and coders become patient advocates, looking for ways to correct problems and work with insurance companies to find solutions. This skill is also useful in helping patients work out payment plans.
Conflict management: To manage emotional or stressful situations professionally and efficiently, medical billers and coders must be resourceful, empathetic and familiar with policies and procedures. This is particularly applicable in negotiating payment plans with patients, devising a solution that works for the patient’s circumstances without jeopardizing the finances of the healthcare organization.
Empathy and compassion: Medical expenses can put an enormous strain on patients and their families. Medical information technology professionals must be compassionate enough to step away from the number-crunching aspect of the job and become the patient’s advocate, looking for ways to get insurance claims approved or working out payment plans for expenses that insurance doesn’t cover.
Proactivity and self-motivation: In this profession, it is important to know how to work independently with minimal supervision. The ability to be proactive in resolving problems or conflicts in a timely manner, which may involve reaching out to insurance company representatives or providers about missing patient information, is an essential quality.
Technical skills required for this career include an understanding of:
Operating systems and databases: Because of the increased reliance on digital systems, medical records technicians are required to be familiar with a range of systems and specialized databases used by healthcare providers and insurers.
Medical terminology: As the medical records technician interprets providers’ notes to determine proper coding, familiarity with common medical conditions, symptoms, tests and medications helps to ensure the accuracy and reliability of their work.
1For the MBC certificate program, all but one course stacks into our Associate Degree in Health Information Technology.
2https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm
3Eligible students who register for and complete the exams may be reimbursed for one exam sitting.
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In New York, DeVry University operates as DeVry College of New York. DeVry University is accredited by The Higher Learning Commission (HLC), www.hlcommission.org. The University’s Keller Graduate School of Management is included in this accreditation. DeVry is certified to operate by the State Council of Higher Education for Virginia. Arlington Campus: 1400 Crystal Dr., Ste. 120, Arlington, VA 22202. DeVry University is authorized for operation as a postsecondary educational institution by the Tennessee Higher Education Commission, www.tn.gov/thec. Naperville Campus: 1200 E. Diehl Rd., Naperville, IL 60563. Unresolved complaints may be reported to the Illinois Board of Higher Education through the online compliant system https://complaints.ibhe.org/. View DeVry University’s complaint process https://www.devry.edu/compliance/student-complaint-procedure.html Program availability varies by location. In site-based programs, students will be required to take a substantial amount of coursework online to complete their program.
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