JOB SUMMARY: The Subspecialty Ophthalmic Clinic Scribe is responsible for providing accurate documentation, summarization of the ocular examination and recommendations, ICD10 coding and CPT in patient charts, while maintaining patient flow and communication regarding appointment status.

The Subspecialty scribe will have working knowledge of their specialty and provide excellent patient care throughout the patient care plan.

Duties and Responsibilities:

• Review patient charts and documents from referring physicians to obtain knowledge of the patient’s disease and order diagnostics related to the patient care plan
• Effectively communicate with all practitioners related to the patient care plan
• Clearly assess and document special requirements related to patient treatments, i.e. A/C tap for patients with lesions close to the nerve
• Supports Site Lead to ensure drug and diagnostic tools are available at each location based on patients’ appointment
• Correctly summarizes and documents what the physician verbalizes during an examination/consultation
• Closes patient charts by EOD unless otherwise approved by physician or direct supervisor
• Correct charts based on guidance from direct supervisor or remote coding team
• Communicate which patients need to be dilated to clinic staff and have the ability to dilate children with drops
• Assist the physician when appropriate and as directed before, during, and after the exam.
• Maintains an awareness of the patient’s verbal and non-verbal communication when the physician is providing instructions as it may be necessary for the scribe to repeat information, provide written instructions, and/or hand out patient education materials for the patient to review at home.
• Effectively communicate with patients through a translator as needed
• Effectively communicate with patients based on their diagnosis and answer patient questions; directs higher level questions i.e. mortality related questions to the appropriate source
• Ensures confirmation of insurance authorization prior to treatment and communicates accordingly
• Facilitates communication between the physician and staff to minimize clinic flow disruptions. This includes review of patients who may need to be rescheduled
• Guides patients to the front desk after completion of exam and ensure proper follow-up appointments are communicated to the front desk to be made before the patient leaves.
• Evaluates the condition of the examination room to ensure adequate supplies are in stock and patients can safely enter and exit the room
• Completes opening and closing duties as needed
• Notifies physicians of changes to the daily schedule, especially emergencies.
• Perform other tasks as assigned.

Skills/Competencies:

• Knows required components of examination for appropriate CPT coding to ensure all elements are accurately completed.
• Understands Medicare and other common insurance requirements for quality reporting to help practice comply with payer requirements.
• Knowledge of and understanding of HIPAA requirements and the importance of maintaining patient confidentiality.
• Thorough understanding of the diseases, symptoms, and treatments for all oncology and/or retina pathologies
• Strong, professional interpersonal skills.
• Typing speed of at least 50 WPM, preferably 60 WPM
• Excellent verbal and written communication to include accurate spelling while charting.
• Ability to work in a Team environment
• Ability to multi-task and solve problems as they arise
• Strong organization skills with attention to detail.
• Computer literacy
• Basic math skills
• Understanding medical terminology and/or ophthalmic terminology.
• Emotional resilience
• Fluency in English, bilingual preferred.

Qualifications:

Education Requirements

• Bachelor’s degree required

Experience Requirements:

• Prior work experience preferred.

PHYSICAL ABILIITES:

• Must be able to be mobile for the entire work shift.
• Must be able to move frequently depending on exam room configuration during clinic sessions.
• Must be able to type or write legibly in a dimly lit setting.
• Must be able to hear softly spoken words.
• Lifting required up to 30 pounds.