What does a Medical Transcriptionist do?
Transcribe medical reports recorded by physicians and other healthcare practitioners using various electronic devices, covering office visits, emergency room visits, diagnostic imaging studies, operations, chart reviews, and final summaries. Transcribe dictated reports and translate abbreviations into fully understandable form. Edit as necessary and return reports in either printed or electronic form for review and signature, or correction.
- Transcribe dictation for a variety of medical reports, such as patient histories, physical examinations, emergency room visits, operations, chart reviews, consultation, or discharge summaries.
- Review and edit transcribed reports or dictated material for spelling, grammar, clarity, consistency, and proper medical terminology.
- Distinguish between homonyms and recognize inconsistencies and mistakes in medical terms, referring to dictionaries, drug references, and other sources on anatomy, physiology, and medicine.
- Return dictated reports in printed or electronic form for physician's review, signature, and corrections and for inclusion in patients' medical records.
- Translate medical jargon and abbreviations into their expanded forms to ensure the accuracy of patient and health care facility records.
- Identify mistakes in reports and check with doctors to obtain the correct information.
- Perform data entry and data retrieval services, providing data for inclusion in medical records and for transmission to physicians.
- Produce medical reports, correspondence, records, patient-care information, statistics, medical research, and administrative material.
- Answer inquiries concerning the progress of medical cases, within the limits of confidentiality laws.
- Set up and maintain medical files and databases, including records such as x-ray, lab, and procedure reports, medical histories, diagnostic workups, admission and discharge summaries, and clinical resumes.
- Perform a variety of clerical and office tasks, such as handling incoming and outgoing mail, completing and submitting insurance claims, typing, filing, and operating office machines.
- Decide which information should be included or excluded in reports.
- Receive patients, schedule appointments, and maintain patient records.
- Receive and screen telephone calls and visitors.
- Take dictation using shorthand, a stenotype machine, or headsets and transcribing machines.