These are some examples of job descriptions we have handpicked from real Medical Scribe resumes for your reference.
- Accompany the physician in exam rooms in order to transcribe the history of a patient’s illness as well as their treatment plan.
- The transcription is treated as a legal medical document in the patient’s chart and therefore accuracy and completeness is vital.
- Able to assist the physicians in locating required information in a patient’s chart due to familiarity of the EMR.
- Worked with multiple physicians within Family Medicine that had different treatment and charting styles and was successfully able to adapt to each individual.
- Spent 500+ clinical hours observing direct patient care, including physical examination, patient interviews, and different medical procedures.
- Helped physicians in charting history, physical examination findings, pertinent results, and medications for each individual patient.
- Alleviated physicians from charting time, allotting them more time for active medical decision making and direct patient care.
- Expedited patients’ visits by updating physicians on recent imaging studies, lab results, or physical progress while in the ER.
- Responsible for the accurate documentation of patient charts in EHR systems.
- Collaborated with medical providers and medical assistants to provide quality patient care.
- Assisted medical assistants with their duties including writing prescriptions and organizing treatment materials for patients.
- Complete medical documentation for physicians and mid level providers accordingly with every patient visit.
- Ensure more accurate reimbursements, records, and more time for physicians to see patients.
- Learn how to maintain professionalism during potentially difficult or aggressive encounters to those truly vital to a patients well being.
- Accompany physician during patient consultations and meticulously document all diagnoses, treatment plans, prescriptions, labs, imaging, and follow-up information to improve consistency, quality and completeness of chart.
- Alongside numerous physicians, learned critical medical decision-making in determining cause of patient ailments.
- Fulfilled 60 hours of training program that included but not limited to: medical terminology, pathophysiology of general medical illnesses, clinical exam findings specific to hips and knees, and appropriate medical testing.
- Reviewed established patients’ charts in preparation for visits.
- Brought patients to exam room where I took all vitals, and asked and recorded electronically the patient’s comprehensive history, including history of present illness, medical/family histories, allergies, and surgeries.
- Relayed all information verbally to the Doctor or Physician Assistant.
- Effectively documented the physician dictated patient history in a time-saving manner to help in making patient care more efficient by transcribing patient orders including history and physical exam as well as laboratory tests, radiology tests, medications, etc.
- Exceeded in performing all clerical and information technology functions for a physician in a fast paced, Emergency Room setting.
- Established and maintained effective working relationships with physicians, staff and managements.
- Trained in medical abbreviations and electronic patient charts.
- Document patient history, symptoms, review of systems, diagnosis, lab and imaging results under physician supervision.
- Provide accurate patient chart documentation in the fast-paced, professional environment of the emergency room.
- Utilize EMR system to keep detailed medical records and patient-care information.
- Translate dictated medical jargon into expanded form; ensuring accuracy of health records.
- Return dictated reports in electronic form for physician review and inclusion into patient medical records.
- Increase the efficiency of emergency attending physicians by performing rapid and accurate completion of medical documentation such as histories, physical exams, reassessment notes, results, procedures, and consults in real-time.
- Notify physician of lab, radiology, and electrocardiogram findings and record their interpretations.
- Electronically write and submit prescriptions to pharmacies, verbally dictated by the physician.
- Proficient in the use of an electronic medical documentation system and medical terminology.
- Assist physician record patient history and physical exam findings into electronic medical record system.
- Document visit, including all diagnoses, treatment plans, prescriptions, and discharge/follow-up information.
- Document procedures completed and recorded diagnostic test results.
- Accompany physician into the patient examination room in order to transcribe a history and physical exam, and document accurately the physician’s encounter with the patient and others present.
- List all proper diagnoses and symptoms as well as follow up instructions and prescriptions as dictated by the physician.
- Transcribe patient orders including laboratory tests, radiology tests, medications, etc.