Medical Administrator/Coder

Job description

Job responsibilities

Key administrative areas:

To work as a member of the clinical coding team:

o with responsibility for own areas

o inputting coded data into the Patient Administration System

o coding from information gathered from several sources including patient notes, discharge forms, both manual and electronic, and other clinical information captured on a variety of sources.

o to ensure clinical coding is recorded in a timely and accurate manner in accordance with both national and the Practice guidelines and standards

o to maintain clinical coding skills and participate in internal training programmes as required for both refresher and specialist clinical coding courses and work toward a high standard of coding

o To extract, interpret and independently code clinical information from clinical letters and Discharge summaries from Hospitals and Clinics

Summarising existing patient records.

Summarising new patient records to a high standard

Restructuring existing computerised notes

Produce a comprehensive electronic summary using SystmOne

Maintaining structure when recording new information.

Assisting GPs with queries relating to medical records

Running data searches to identify relevant information

To work with other administrators and healthcare professionals to provide a first-class service to our patients

To participate in quality improvement initiatives, identifying areas where the processes used within the coding function can be improved and assist in implementing

Photocopying, scanning and filing of paper records

Process scanning daily for incoming patient documentation in line with the practice procedure

Any other reasonable tasks at the request of the Practice Manager

To have an excellent understanding of the Quality and Outcomes Framework (QOF) and work towards achieving national targets.

Assist with the capture, monitoring and extraction of data for audit or QOF/Enhanced Services.

Run regular monthly searches for recall systems and create patient invites via text message, telephone or letter.

Update computer/data input protocols as required.

Attend and participate in MDT meetings as required

Undertake such duties as may be required from time to time to support the day-to-day functioning of the practice; such as supporting the reception team with answering calls and booking appointments.

Handling inbound referrals to the practice (long acting contraception)

Communication:

Communicate effectively with other team members

Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating

Maintain effective communication within the organisation

Confidentiality:

In the course of 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 staff will respect their privacy and act appropriately

In the performance of the duties outlined, the post-holder may have access to confidential information relating to patients and their carers, practice staff and other healthcare workers. They may also have access to information relating to the practice as a business organisation. All such information from any source 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 data.

Any breach of confidentiality is a disciplinary event and will be treated as gross misconduct which could result in termination of employment

Health & Safety:

The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety Policy, to 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 way and free from hazard

Reporting potential risks identified.

Equality and Diversity:

The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include:

Acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation

Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues

Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their 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, including Statutory and Mandatory training. Such 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.

Attend and participate in practice meetings as required

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 individuals in other agencies to meet patients needs

Effectively manage own time, workload and resources.

Contribution to the Implementation of Services:

The post-holder will:

Apply practice policies, standards and guidance

Discuss with other members of the team how the policies, standards and guidelines will affect own work

Participate in audit where appropriate

Implement maximum flexibility of work to maintain a high level of efficiency, eg working in any area of the practice if requested to do so, according to the needs of the practice

Comply at all times to the Staff Contract, Practice Policies & Procedures including CQC policies, Data Protection & GDPR

Feedback:

To listen to feedback from patients and colleagues whether this be a compliant, comment or compliment and if it cannot be dealt with immediately to the Practice Manager.

CQC:

To work within the guidelines set be CCQ to ensure the Practice is safe, efficient and provides the best possible care for patients.

N.B. This job description is a reflection of the current position and the post holder is expected to view it as a guide rather than an exact description of all duties and responsibilities. It may be subject to variation from time to time.

Person Specification

Skills/Competencies/Disposition

Essential

• Evidence of working with IT systems
• Evidence of ability to support collection and analysis of data
• Excellent verbal and written skills
• Ability to provide and receive complex information
• Excellent interpersonal skills
• Demonstrable ability to show kindness and compassion
• Demonstrate ability to reflect and learn from situations
• Identifies difficulties as challenges and works with others to identify solutions
• Demonstrates co-operative team working and awareness of the roles of other professionals
• Able to work on own initiative, organising and prioritising own workload to set deadlines
• Ability to adapt and change approach when needed
• Persistence and ability to keep going in difficult situations and with complex and uncertain pieces of work
• Understanding of and commitment to equality of opportunity and good working relationships
• An ability to maintain confidentiality and trust
• Can do attitude, able to maintain positivity in the face of adversity
• Good time keeping
• Flexible approach to work
• Ability to work flexibly across days of the week

Desirable

• Experience of using a medical software package SystmOne

Qualifications

Desirable

• NVQ Level 3 or equivalent level of knowledge in office procedures

Experience

Essential

• Experience of working in medical administration
• Experience in coding medical documents
• Experience of working under own direction
• Experience in a patient focused environment
• Previous experience in NHS/Primary Care/Local Authority role

Desirable

• Evidence of experience in wide range of administrative systems and software programmes
• Experience of supporting service improvement

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Employer details

Employer name

Hartshill Medical Centre

Address

Ashwell Road

Stoke-on-trent

ST4 6AT

Employer's website

https://www.hartshillsurgery.co.uk/ (Opens in a new tab)