RN - Clinical Data Abstractor

PRIMARY RESPONSIBILITIES

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  Interacts with physicians and nursing staff in the process of departmental abstraction of their patients’ medical information. Obtain required records from referring physicians and primary care providers.
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  Abstracts appropriate clinical information from outside medical records and inputs into the EHR database for Best Care/Best Results.
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  Reviews outside records for information vital to specific referral, focusing on medical history, surgical history, allergies and medications. Inputs abstracted data into appropriate defined areas of EHR.
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  Ensures data is abstracted within established timeframes to ensure continual flow of information and increase efficiency of office visits facilitating patient entry into specialty services.
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  Applies evidenced based practices to achieve multidisciplinary collaboration and to facilitate continuity of care.
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  Contributes to the overall satisfaction of the department by actively participating in department functions and offering assistance to others as needed.
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  Works in a constant state of alertness and safe manner.
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  Performs other duties as assigned.

EDUCATION

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  Graduate of accredited school of nursing

EXPERIENCE

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  Two years' registered nurse experience

PHYSICAL REQUIREMENTS

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  Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
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  Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
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  Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
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  Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
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  Frequent keyboard use/data entry.
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  Occasional bending, stooping, kneeling, squatting, twisting and gripping.
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  Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
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  Rare climbing.