CAREER GUIDE FOR MEDICAL RECORDS AND HEALTH INFORMATION TECHNICIANS

 

SOC Code:     29-2071

 

Pay Band(s):  3  (Salary Structure)

 

Standard Occupational Description: Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system. Process, maintain, compile, and report patient information for health requirements and standards.

 

Medical Records and Health Information Technician positions in the Commonwealth are assigned to the following Roles in the Administrative and Office Support Career Group:

 

Administrative and Office Specialist III

           

While Medical Records and Health Information Technicians within the Commonwealth are all located within the Administrative and Office Support Career Group, individuals may want to pursue other opportunities within the Commonwealth depending upon individual training, education, knowledge, skills, abilities, and interests.   

 

Other Career Group(s) that may be of interest are:

Health Care Compliance

Program Administration

SKILLS, KNOWLEDGE, ABILITIES AND TASKS

(Technical and Functional Expertise)

 

Skills

Note: The technical and functional skills listed below are based on general occupational qualifications for Medical Records and Health Information Technicians commonly recognized by most employers.  Typically, you will not be required to have all of the skills listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

 

1.      Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

2.      Understanding written sentences and paragraphs in work related documents.

3.      Managing one's own time and the time of others.

4.      Talking to others to convey information effectively.

5.      Communicating effectively in writing as appropriate for the needs of the audience.

6.      Understanding the implications of new information for both current and future problem solving and decision-making.

7.      Teaching others how to do something.

8.      Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

9.      Being aware of others' reactions and understanding why they react as they do.

10. Selecting and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things.

 

Knowledge

Note: The technical and functional knowledge statements listed below are based on general occupational qualifications for Medical Records and Health Information Technicians commonly recognized by most employers.  Typically, you will not be required to have all of the knowledge listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

 

The Knowledge of:

1.      Administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

2.      Principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

3.      The structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.

4.      Computer hardware and software, including applications and programming.

5.      Coding and indexing of diseases and medical procedures.

 
Abilities

Note: The technical and functional abilities listed below are based on general occupational qualifications for Medical Records and Health Information Technicians commonly recognized by most employers.  Typically, you will not be required to have all of the abilities listed to be a successful performer.  Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.

The Ability to:

 

1.      Listen to and understand information and ideas presented through spoken words and sentences.

2.      Read and understand information and ideas presented in writing.

3.      Communicate information and ideas in speaking so others will understand.

4.      Arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).

5.      See details at close range (within a few feet of the observer).

6.      Speak clearly so others can understand you.

7.      Generate or use different sets of rules for combining or grouping things in different ways.

8.      Identify and understand the speech of another person.

9.      Communicate information and ideas in writing so others will understand.

10. Tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.

 

Tasks

Note:  The following is a list of sample tasks typically performed by Medical Records and Health Information Technicians.  Employees in this occupation will not necessarily perform all of the tasks listed. 

Tasks

  1. Protect the security of medical records to ensure that confidentiality is maintained.
  2. Process patient admission and discharge documents.
  3. Review records for completeness, accuracy and compliance with regulations.
  4. Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
  5. Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures and treatment into computer.
  6. Release information to persons and agencies according to regulations.
  7. Plan, develop, maintain and operate a variety of health record indexes and storage and retrieval systems to collect, classify, store and analyze information.
  8. Manage the department and supervise clerical workers, directing and controlling activities of personnel in the medical records department.
  9. Transcribe medical reports.
  10. Identify, compile, abstract and code patient data, using standard classification systems.
  11. Chair medical records committees and resolve documentation issues.

 

INTERESTED?

 

Like people, occupations have traits or characteristics.  These characteristics give important clues about the nature of the work and work environment, and give you an opportunity to match your own personal interests to a specific occupation.  When you choose a job in an occupation that matches your own interests you have taken an important step in planning a successful and rewarding career.

 

Medical Records and Health Information Technology is a Conventional occupation.  Conventional occupations frequently involve following set procedures and routines and can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.

 

LICENSURE, REGISTRATION, OR CERTIFICATION REQUIREMENTS

 

Generally this is not required for Medical Records and Health Information Technician positions in state government, however, career opportunities significantly improve if registration is obtained.

 

According to the Department of Labor, most employers prefer to hire Registered Health Information Technicians (RHIT), who must pass a written examination offered by the American Health Information Management Association (AHIMA). To take the examination, a person must graduate from a 2-year associate degree program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) of the American Medical Association. Technicians trained in non-CAAHEP-accredited programs, or on the job, are not eligible to take the examination. In 2003, CAAHEP accredited 182 programs for health information technicians. Technicians who specialize in coding may obtain voluntary certification.

 

The Health Information associate degree programs at Northern Virginia Community College (http://www.nvcc.vccs.edu/) and Tidewater Community College (http://www.tcc.vccs.edu/) are accredited by the CAAHEP.

 

Information on becoming a Registered Health Information Technician and on careers in medical records and health information technology is available from the American Health Information Management Association, 233 N. Michigan Ave., Suite 2150, Chicago, IL 60601-5800, or on the web at http://www.ahima.org.

 

EDUCATIONAL, TRAINING, AND LEARNING OPPORTUNITIES 

 

From the Department of Labor:

 

Medical records and health information technicians entering the field usually have an associate degree from a community or junior college. In addition to general education, coursework includes medical terminology, anatomy and physiology, legal aspects of health information, coding and abstraction of data, statistics, database management, quality improvement methods, and computer science. Applicants can improve their chances of admission into a program by taking biology, chemistry, health, and computer science courses in high school.

 

Hospitals sometimes advance promising health information clerks to jobs as medical records and health information technicians, although this practice may be less common in the future. Advancement usually requires 2 to 4 years of job experience and completion of a hospital's in-house training program.

 

COMMONWEALTH COMPETENCIES

 

Competencies are a set of identified behaviors, knowledge, skills, and abilities that directly and positively impact the success of employees and the organization. Competencies can be observed and measured.  When consistently demonstrated, competencies make employees particularly effective in their work.  Competencies help lay out a road map to career success.  You can use the Commonwealth Competencies to help improve your individual performance by adopting behaviors that make high performing employees successful in their jobs. In this way, you can use the Commonwealth Competencies for your further professional development.

 

The Commonwealth Competencies are:

 

1.      Technical and Functional Expertise

2.      Understanding the Business     

3.      Achieving Results

4.      Serving the Customer

5.      Teamwork

6.      Interpersonal and Communication Skills

7.      Leadership and Personal Effectiveness

 

The above competencies may be applied to employees throughout the Commonwealth of Virginia.  They can be rank-ordered by agencies and hiring managers to represent the needs of a specific job.  The rank ordering will change depending upon the occupation, an organization's priorities, the actual job requirements, and the supervisor's preferences. 

 

Career success is both about what you do (applying your technical knowledge, skills, and ability) and how you do it (the consistent behaviors you demonstrate and choose to use) while interacting and communicating with others.  Hopefully, by studying the Commonwealth competencies, identifying your developmental opportunities, and working to refine your own competence, you can take charge of your career!

 

For additional information about the Commonwealth Competencies go to: http://jobs.state.va.us/cc_planningctr.htm.  For the competencies, we first list the competencies and then define each.  Finally, we list competency indicators; to describe what successful performance looks like. 

COMMONWEALTH CAREER PATH

 

Career opportunities in the Commonwealth are not limited to moving “up” to the next highest role and pay band, changing positions, or to becoming a supervisor.  That's because most roles describe a broad group of occupationally related positions that perform a range of work that requires increased knowledge and skills.  For that reason, Commonwealth roles describe the career paths within the same or higher-level role for the same or different Career Group.  The broad salary range and the Commonwealth's pay practices provide flexibility in recognizing career development and advancement. (Salary Structure)

 

For example:

 

Pay

BanD

Practitioner Roles

1

Administrative & Office Specialist I

 

 

2

Administrative & Office Specialist II

 

 

3

Administrative & Office Specialist III

 

Sample Career Path

 

Administrative and Office Specialist I

The Administrative and Office Specialist I role provides career tracks for operational and administrative support specialists such as the office support aides or postal aides providing entry-level support by performing well-defined office duties of a routine and repetitive nature under close supervision. The range of duties includes, but is not limited to, alphabetizing, filing, photocopying, sorting, delivering mail, and/or routine document processing.

 

Administrative and Office Specialist II

The Administrative and Office Specialist II role provides career tracks for operational and administrative support specialists such as office support assistants and secretaries who perform a wide variety of journey-level office/program and administrative support duties based on agency business needs. Duties are performed within specific guidelines using established policies and procedures. The range of duties includes, but is not limited to, general office, secretarial, fiscal, and support activities.

Administrative and Office Specialist III

The Administrative and Office Specialist III role provides career tracks for operational and administrative support specialists, such as fiscal technicians, human resource assistants, claims technicians, medical records technicians, procurement technicians, licensing specialists, customer services representatives, executive secretaries, administrative assistants, office supervisors, and facilities coordinators. Duties range from journey-level to supervisory level and may include compliance assurance, report writing, reconciliation of information or financial data, records management, scheduling, claims review and processing, data collection and analysis, research, inventory, budget management, personnel administration, and funds collections or expenditures.

 

Medical Records and Health Information Technicians typically will need formal education and registration to advance to Medical Records Administrator Positions in the Program Administration Career Group.

 

ADDITIONAL OCCUPATIONAL INFORMATION CAN BE FOUND AT: 

 

American Health Information Management Association

http://www.ahima.org.

 

Northern Virginia Community College

http://www.nvcc.vccs.edu/

 

Tidewater Community College

http://www.tcc.vccs.edu/

 

O*NET (Occupational Information Network) 

http://online.onetcenter.org/gen_search_page

 

Virginia Employment Commission 

http://www.alex.vec.state.va.us/

 

Career One Stop

http://www.careeronestop.org/

Virginia Career Resource Network

http://www.vacrn.net/