Primary function.
- Works in the Family Medicine Clinic to provide care to patients.
- Will perform rooming patient, taking vitals, history, medications and updating them into the patient’s chart in the Electronic Medical Record.
- Will Make sure the chart is updated and then let the provider know that the patent has arrived and is ready to be seen.
- Will assist with any other office duties as asked by the provider or head nurse in the clinic.
- Some of these duties may include prior authorizations, medical record scanning into the Electronic Medical Record.
Duties and Responsibilities
- 1. Works in clinic to meet provider, patient, and department needs.
- Room patients and take vitals, update EMR with new patient information.
- Communicate patient issues and reason for visit, update medications into the EMR.
- Maintains individual patient files with appropriate documentation.
- 2. Performs specific care based on individualized medical plan of care.
- Performs patient assessment in accordance with the applicable patient type.
- Identifies abnormal symptoms/changes in patients clinical, mental, or emotional condition reporting finding to the provider.
- Assist in patient procedures with the physician or nurse as determined by policy and standard of care.
- Assists with patient admission and discharge processes as directed by the provider/nurse.
- Provides and explains dismissal instructions verbally and with written instruction sheets as directed by provider of APRN.
- 3. Maintains and performs all patient documentation in a timely, and factual manner.
- Utilizes only approved abbreviations in all documentation.
- Accurately reflects care provided.
- Follows all Policies and procedure related to documentation requirements.
- 4. Performs emergency treatment as required.
- Follows emergency policies and procedures and standards of BLS.
- 5. Promotes and ensures patient safety in all aspects of responsibilities.
- Follows procedures and protocols to ensure safe administration of mediations and monitoring for adverse effects.
- Utilizes proper body mechanics, transfer/lifting techniques to minimize fall risk to patient and injury to self.
- Implements infectious disease controls as appropriate including isolation procedures, proper use of hand washing and gloves, specimen collection and transport and during cleaning processes of rooms or equipment/instruments.
6. Performs all other duties as assigned.
Qualifications
- include:
- Medical Assistant Certification not mandatory, training preferred.
- Current CNA, LPN, or RN license in the State of Missouri is required for these job titles.
- Able to take Vitals and record them into the Electronic Medical Record
- BLS certification required. If certifications are not current upon hire, must be completed within sixty days of hire.
- Electronic Medical Record technology preferred.
Working conditions
Incumbents will be exposed to viruses, disease, infection from patients.
Physical requirements
While performing the duties of this job, the employee is regularly required to speak and listen. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. This position requires intermittent physical activity, including standing, walking, bending, kneeling, stooping and crouching as well as lifting and supporting patients.
