Job Description

A medical scribe’s primary duties are to assist providers throughout their workday and chart patient encounters in real-time using a medical practice’s electronic health record (EHR). Medical scribes may also generate referral letters for physicians, manage and sort medical documents within the electronic health record system, and assist with work notes.

Medical scribes can be thought of as data care managers, enabling physicians to focus on patient care, most commonly in an emergency department or clinic/office setting. By handling data management tasks for physicians in real-time, scribes free the physician to increase patient contact time, give more thought to complex cases, better manage patient flow, and increase productivity.

Time Commitment: A minimum commitment of 12 months (part-time or full-time) is required of all scribes.

Responsibilities

• Record details of patient’s chief complaint, history of present illness, review of systems, past medical history, social history, family medical history, disease risk factors, medications and allergies.
• Record details of physical exam, including pertinent positives and negatives, noted abnormalities and patient general condition.
• Record physician orders and check for order results. If orders are not completed in a timely fashion or if results are incomplete, troubleshoot for causes and solution.
• Assists in disposition of patient, whether discharged or admitted, including discharge instructions, admission orders, and prescription forms.
• Ensures compliance with EMR-required measured data, such as Meaningful Use criteria and Medical Decision Making.

Job Requirements

Accuracy, organization and thoroughness are the greatest virtues of a scribe. Professionalism in every aspect of performance, most notably in attitude, is also essential.

Education: Preferably at least two years of college in a healthcare related field.

Training Overview

We understand the broad scope of demands that must be fulfilled by our scribes to ensure seamless integration into the daily operations of our clients. Our scribes undergo an exhaustive selection and interview process to identify candidates that are highly-motivated, responsible and dedicated. Most find themselves pursuing degrees in medicine, physician assistant studies or nursing.

Our training program is one of the most thorough onboarding programs in the industry. The program involves an extensive didactic portion and also includes patient simulations, shadowing of existing scribes, and several live in-person training shifts. The training program lasts four to eight weeks, depending on experience.

Extensive mentoring, close supervision, and ongoing performance evaluations of our scribes ensures adherence to the strictest service standards.