Job responsibilities
- Checking and integrating medical records received electronically
- Examining records and documentation for missing information
- Assigning industry-recognised codes
- Ensuring that all QOF related data is captured
- Maintain and improve a knowledge of anatomy, physiology and medical terminology
- Use medical knowledge to correct mistakes found in existing patient records.
- Collaborating with clinical colleagues and other healthcare professionals to ensure information accuracy
- Ensuring that the practice complies with clinical coding guidelines
- Ensuring that all clinical codes are current
- Following practice protocols to ensure consistent and high-quality care is provided to our patients.
Confidentiality
While seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that the staff with respect their privacy and act appropriately.
In the performance of the duties outlined in the job description, the post-holder may have to access to confidential information relating to patients and their carers, practice staff and other healthcare workers. They may also have access to information from any source which is to be regarded as strictly confidential.
Information relating to patients, carers, colleagues, other healthcare workers or the business of the practice may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive information.
Health & Safety:
The post-holder will assist in prompting and maintaining their own and others health, safety and security as defined in the practice health and safety policy, the practice health and safety manual and the practice infection control policy and published procedures. This will include:
Using personal security systems within the workplace according to practice guidelines.
Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks.
Making effective use of training to update knowledge and skills.
Using appropriate infection control procedures, maintaining work areas in a tidy and safe wat and free from hazards.
Actively reporting of health and safety hazards and infection hazards immediately when recognise.
Keeping own work area and general/ patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holders role.
Undertaking periodic infection control training (minimum annually).
Reporting potential risks identified.
Equality & Diversity
The post-holder will support the equality, diversity and rights of the patients, carers, and colleagues to include:
Acting in a way that recognises the importance of peoples rights, interpreting then in a way that is consistent with practice procedures and policies and current legislations.
Respecting the privacy, dignity, needs and beliefs of patients, carers, and colleagues.
Behaving in a manner which is welcoming to and f the individual, is non-judgemental and respects circumstances, feelings, priorities, and rights.
Personal/Professional Development:
The post-holder will participate in any training programme implemented by the practice as part of this employment, such as training to include:
Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/ or professional development.
Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work.
Quality:
The post-holder will strive to maintain quality within the practice and will:
Alert other team members to issues of quality and risk.
Assess own performance and take accountability for own actions, either directly or under supervision.
Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance.
Work effectively with individual in other agencies to meet patients needs.
Effectively manage own time, workload, and resources.