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THE JOB
Managing a health information system that meets medical, administrative,
ethical and legal requirements involves MEDICAL RECORD/HEALTH INFORMATION
TECHNICIANS AND ADMINISTRATORS, clerks and transcriptionists - known
collectively as medical records personnel. Their work is crucial to both
patients and health care facilities. For patients, carefully maintained
records guarantee continuity of care; for the facility, precise coding of
diagnoses and procedures can mean timely fee payments by patients and health
insurance providers. Databases they create are essential to disease
Research and control.
Medical Record Coders (also called Health Information Coders) assign
diagnostic and procedure codes to records of discharged patients to produce
a comprehensive clinical care history (database). To do the coding, they
review and screen the entire medical record to create an abstract which
summarizes such clinical data as diseases, therapies, surgeries, lab tests
and pharmaceuticals. The main coding systems used are: the International
Classification of Disease System for statistical reporting and the
Diagnostic Related Groupings codes to bill patients or their insurers.
Medical Record Technicians (also called Health Information Technicians)
organize, analyze and evaluate medical records. They compile medical care
and census data for reports on types of diseases treated, surgery done and
rate of hospital bed use. This information is used by law firms, insurance
companies and government agencies. Technicians consult with doctors to
resolve or clarify codes for conflicting or unclear information and
participate in the coding team's regular meetings. They must know coding
system regulations and any changes made by official agencies that affect
coding information policies. They also need to understand third-party
reimbursement regulations--payment procedures of health insurance firms and
health maintenance organizations.
Tumor Registrars are medical records specialists who review cancer patient
health records to identify, compile and analyze patient data for use in
cancer management. They summarize and code other information such as
demographics, history and stage of cancers; diagnostic methods and
treatments. They contact patients, their families and physicians to gather,
evaluate and record follow-up information about the quality of life and
length of survival. Statistical, graphic and written reports are prepared
by registrars for medical staff, Researchers and other registry users.
Medical Records Administrators (also called Health Information
Administrators) plan, develop, and coordinate systems for managing health
information in health services facilities, health financing organizations,
and quality review agencies. Administrators direct medical record
departments of medical services centers. They advise other staff
administrators on procedures for keeping complete and accurate medical
records that comply with State and federal standards. As custodians of
confidential patient information, administrators are experts in the legal
process for releasing medical information. They might testify in court
about their information management practices.
Administrators with appropriate experience function as consultants to
skilled nursing facilities and small health services firms such as kidney
dialysis and ambulatory care clinics that do not need full-time
administrators. Some are employed with accounting and computer service
companies that manage information systems. Others teach medical record
technology in colleges.
WORKING CONDITIONS
Workers in this field have a modern office environment complete with
sophisticated and costly computer equipment. There may be pressures from
the demand to efficiently run a vast and growing health information system
that has quick data storage and retrieval.
EMPLOYMENT OUTLOOK
The following information is from the California Projections of Employment
published by the Labor Market Information Division.
Medical Record Coders, Technicians and Tumor Registrars
Estimated number of workers in 1993 6,760
Estimated number of workers in 2005 11,030
Projected Growth 1993-2005 63%
Estimated openings due to separations by 2005 2,020
(These figures do not include self-employment or openings due to turnover.)
The relatively small occupation of Medical Records Technicians, which
includes Coders, Technicians, and Tumor Registrars, is expected to grow more
than twice as fast as the average for all occupations through 2005.
Jobs for Medical Record Administrators will grow faster than average.
Opportunities are expected to be favorable because of changes in health care
reimbursement based on clinical data from medical records. Jobs will also
occur as workers change careers or leave the labor market. Few people are
trained to enter this profession. New graduates, especially those willing
to relocate, should easily find a job.
ENTRANCE REQUIREMENTS AND TRAINING
Medical Record Coders earn a certificate to become certified coders through
a one-year community college program or through adult education, Regional
Occupation Programs (ROP) or private schools. Medical Record Technicians
need an associate degree. Graduates are eligible to take the test given by
the American Health Information Management Association (AHIMA) to be
certified as Accredited Record Technicians (ARTs). California requires
certification only for those technicians who actually manage medical record
departments.
Tumor registrars are Medical Record Technicians who were trained on the job to
be specialists.
According to the California Health Information Association the eight
accredited Medical Records Technician programs in California are:
City College of San Francisco
San Francisco, CA
(415) 561-1818
Cypress College
Cypress, CA
(714) 826-2220
Chabot College
Hayward, CA
(510) 786-6898
East Los Angeles College
Los Angeles, CA
(213) 265-8884
Charles R. Drew University
Los Angeles, CA
(213) 563-5888
Loma Linda University
Loma Linda, CA
(909) 824-4976
Consumnes River College
Sacramento, CA
(916) 688-7244
San Diego Mesa College
San Diego, CA
(619) 560-2606
Medical Record Administrators must be certified as registered record
administrators (RRAs) by the AHIMA or already be certified ARTs. Most RRAs
have a BA degree in the field.
Loma Linda University is the only accredited California school with a BA
degree program in health information administration. Concentration studies
begin in the final years, making it possible for sophomores or juniors to
transfer from other four-year institutions or community colleges. Graduates
with other BA degrees that include required science courses may be admitted
to a one-year post-graduate certificate.
Contact the California Health Information Association for a list of
accredited out-of-state schools offering BA degrees programs. Most BA
programs are independent study and non-residential programs that can be
completed through correspondence and pre-arranged student/instructor
conferences.
WAGES, HOURS, AND FRINGE BENEFITS
Wages vary with size, kind and location of health care centers, and worker
experience levels. Medical Record Technicians, Coders and Tumor Registrars
in California earn a median wage of $9.67 hourly. Coders tend to earn less.
Registered Record Administrators earn an average salary of over $49,000 a
year.
The typical work week is 40 hours. Fringe benefits almost always include
paid vacations, holidays, and sick leave, in addition to paid health and
retirement plans.
ADVANCEMENT
The natural career path for ARTs, Coders and Tumor Registrars is advancement
to RRAs after getting the needed education and experience. After required
training and experience, Coders move up to ARTs and, ultimately, RRAs.
Medical Record Administrator advancement depends on the size of the health
care facility. In large centers, they may start as assistant administrators
and advance to director of medical record departments. Some become
consultants to a cluster of small clinics, to health Researchers, or to
contractors that manage health information systems. Graduate degrees are
becoming more important for advancement in this field.
FINDING THE JOB
Networking through professional associations and using professional health
industry search firms are the most common ways to find job leads. Job
seekers should also apply directly to health services centers, health
Research firms, computer and accounting companies specializing in health
information, and State and federal agencies and private contractors
responsible for managing the Medicare Health Insurance program. Recent
graduates should apply with their school placement office.
Medical Record Administrators often get hired before graduation through
instructor recommendation and placement.
ADDITIONAL SOURCES OF INFORMATION
American Health Information Management Association
919 North Michigan Avenue, Suite 1400
Chicago, IL 60611-1683
(312) 787-1540
California Health Information Association
5108 East Clinton Way, Suite 113
Fresno, CA 93727
(209) 251-5038
National Cancer Registrar
505 E. Hawley Street
Mundelein, IL 60060-2458
(847) 566-0833 Fax: (847) 566-7282
RELATED OCCUPATIONAL GUIDES
Medical Secretaries No. 177
Hospital and Health Services Administrators No. 235
OCCUPATIONAL CODE REFERENCES
DOT (Dictionary of Occupational Titles, 4th Ed., 1991)
Medical Record Administrator 079.167-014
Medical Record Technician 079.362-014
Tumor Registrar 079.362-018
OES (Occupational Employment Statistics) System
Medicine and Health Services Managers 150080
Medical Record Technician 329110
Source: State of California, Employment Development Department,
Labor Market Information Division, Information Services Group,
(916) 262-2162.
Note: This is NOT a job opening. The purpose of This California Occupational Guide
is to provide you with useful information to help you make career decisions.
If you are searching for a job, go to:
California Occupational Guides
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