Coder/summariser

Duties and responsibilities:

The following list of duties should not be regarded as definitive as they may be reviewed from time to time to take account of changing circumstances.

Review all incoming correspondence and enter, using recognised codes, pertinent information into the patients electronic medical record in accordance with the coding protocol.

Accurate and timely coding of patient information gathered from paper and electronic medical records, as well as correspondence received from other healthcare providers.

Follow up actions from correspondence based on internal processes and protocols that will ensure that patients receive the most appropriate services and continuity of care.

Working closely with internal clinical and administrative staff to ensure optimal levels of patient care and timely follow up actions.

Process and scan inbound clinical correspondence into patients electronic medical record in accordance with the scanning protocol.

Organise the medical record of patients whom you are coding, to harmonise problem titles, group symptom development and assign the appropriate status to medical information.

Recognise own knowledge limits and seek advice from clinical or administrative colleagues as appropriate.

Process/summarise new incoming medical notes in accordance with the summarising protocol.

Culling and sorting of patient records and letters in preparation for summarising Reviewing medical records and producing an accurate summary of the patients medical history To interpret reports from hospitals to ensure accuracy of the coding process.

Deal with any queries relating to clinical coding. Monitoring progress of notes summarising against Practice targets.

Scanning of patient related documentation and attaching scanned documents to patients healthcare records. Input data into the patients healthcare records as necessary.

Maintain a clean, tidy, effective working area at all times Please see the attached job description and person specification for further details.

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