WVUH-Scribe-86964

WVU Medicine; Morgantown, Northern (WV, KY); On-site; USD 17,000 - 22,000; Full time

Job summary

West Virginia University Health System is seeking a Scribe to document physician dictations and activities into the medical record as an unlicensed member of the team. This role supports accurate charting and efficient patient care at WVU Health System clinics in Morgantown.

The position involves recording history and physicals, documenting procedures, and gathering data for review by the physician. It requires strong medical terminology knowledge, fast typing, and strict privacy compliance;

Qualifications

• High School Diploma or equivalent.
• Background check as required for regulated areas.

Responsibilities

• Document physician dictations into the medical record for approval.
• accompany physician to patient examinations to transcribe history and physicals.
• Document procedures performed in the medical chart.
• Transcribe consultations or discussions with family or other physicians.
• Gather lab and radiology results; data reviewed by physician before entry.
• Monitor data progression to complete patient workup.
• Cannot provide or relay verbal orders; orders go through physician.
• Can answer calls for the physician but may not take medical data over the phone.
• Cannot give medical advice or care plans to patients or families.
• Communicate waits and delays as directed by staff.
• Print physician processes as directed.

Skills

Medical terminology

Computer proficiency

Communication

Organizational skills

Privacy awareness

Typing 50 wpm

Core competencies

Education

High School Diploma

Job description

As an unlicensed member of the team, this position is responsible for documenting the physician’s or licensed independent practitioner’s dictation and/or activities into the medical record.

MINIMUM QUALIFICATIONS

• High School Diploma or equivalent.
• State criminal background check and Federal (if applicable), as required for regulated areas.

CORE DUTIES AND RESPONSIBILITIES

• 1. For history of present illness, past medical history, review of systems, medications, social history, family history, allergies or other elements of the patient chart: The physician or licensed independent practitioner will elicit the information as usual and Scribes will record the information in the chart for approval.
• 2. The Scribe may accompany the physician or licensed independent practitioner in the patient examination area in order to transcribe a history and physical examination as given by the patient and physician or licensed independent practitioner.
• 3. The Scribe documents in the medical chart any procedures performed by the physician or licensed independent practitioner, or nurses.
• 4. The Scribe transcribes any consultations or discussions with family and/or the patient’s private physician or the on-call physician.
• 5. Scribes may gather laboratory results, radiology results, medical records and other data for review by the physician or licensed independent practitioner. Data should not be entered into the EMR, chart, or otherwise incorporated into the medical record until it has been reviewed and approved by the physician’s or licensed independent practitioner.
• 6. Scribes must continuously check on the progress of this data in order to get the patient’s workup complete so that the physician or licensed independent practitioner is able to make treatment decisions.
• 7. The Scribe may not provide verbal orders or relay verbal orders between the physician or licensed independent practitioner and other patient care providers. The physician or licensed independent practitioner must communicate orders directly to other care providers.
• 8. Scribes can make and answer calls for the physician or licensed independent practitioner, however Scribes may not take medical data over the phone.
• 9. Scribes may not give medical advice, communicate medical information or care plans of any kind directly with the patient or patient’s family or friends.
• 10. Scribes can communicate waits and delays as directed by the RN or physician or licensed independent practitioner.
• 11. Scribes may print the physician’s or licensed independent practitioner process at the physician or licensed independent practitioner’s direction.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORKING ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS AND ABILITIES

• 1. Working knowledge of medical terminology and accepted abbreviations.
• 2. Computer proficiency and ability to quickly learn new applications.
• 3. Communication skills and the ability to coordinate and cooperate with multiple members of the health care team.
• 4. Organizational skills with focus on tracking patient care and improving patient flow.
• 5. Professional demeanor and recognition of privacy considerations for patients and families.
• 6. Typing speed of 50 wpm preferred.
• 7. Position is subject to core competencies and quality assurance monitoring.

Additional Job Description

• Must be available to work clinic hours 8A to approximately 5P Monday- Friday.
• Scheduled Weekly Hours: 36
• Shift: Exempt/Non-Exempt: United States of America (Non-Exempt)
• Company: WVUH West Virginia University Hospitals
• Cost Center: 8815 UHA Scribes
• Address: 1240 Suncrest Towne Centre Morgantown West Virginia

Equal Opportunity Employer

Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

The West Virginia University Health System is West Virginia’s largest health system and largest private employer, providing care to communities across West Virginia, Maryland, Ohio, and Pennsylvania. The integrated academic health system includes 25 hospitals and five institutes, with more than 3,500 licensed beds, 4,000 clinicians, 39,000 employees, and $8.5 billion in annual operating revenues. Anchoring the system in Morgantown, West Virginia, are WVU Hospitals, an 880-bed academic medical center, and the 150-bed WVU Medicine Golisano Children’s Hospital. Together, the Health System’s hospitals, clinics, and specialty programs provide a comprehensive continuum of care, ranging from community-based primary and specialty services to highly complex, quaternary care and post-acute care.