Medical Records Specialists
Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the healthcare system. Classify medical and healthcare concepts, including diagnosis, procedures, medical services, and equipment, into the healthcare industry's numerical coding system. Includes medical coders.
SOC: 29-2072.00
Common Job Titles
Health Information Technician (Health Information Tech)Medical Records ClerkMedical Records CoordinatorRegistered Health Information Technician (RHIT)
What You'll Need to Succeed
AI-generatedKey competencies for this occupation at a glance
- MindsetUphold patient confidentiality and data privacy standards when handling sensitive medical records in accordance with ethical, legal, and regulatory requirements.Advanced
- KnowledgeClassify medical diagnoses, procedures, and services into standardized coding systems (ICD, CPT, HCPCS) using encoder software and coding databases to ensure accurate reimbursement and compliance.Proficient
- KnowledgeEvaluate medical documentation for completeness, accuracy, and compliance with regulatory requirements in hospital and clinic settings, following HIPAA and healthcare industry standards.Proficient
- KnowledgeGenerate reports and statistical analyses on coding accuracy, reimbursement trends, and documentation quality using database tools such as Microsoft SQL Server, Tableau, and statistical software.Proficient
- KnowledgeValidate coded medical data for accuracy against DRG grouping and billing requirements to support proper reimbursement and prevent claim denials.Proficient
- KnowledgeOrganize medical records filing and retrieval systems using computerized indexing, document management platforms like Laserfiche, and chart tracking software to ensure timely access.Proficient
- KnowledgeApply electronic medical record (EMR) systems and health information management software to compile, process, and maintain patient medical records across multiple platforms including Epic Systems and MEDITECH.Developing
- KnowledgeAnalyze clinical documentation and physician notes to extract appropriate diagnostic and procedural information for coding assignment.Developing
- KnowledgeInterpret medical terminology, anatomy, and pathophysiology within patient records to ensure accurate coding and classification of healthcare services.Developing
- Hands-onOperate document scanning and imaging equipment including barcode scanners, flat-top scanners, and DICOM medical imaging systems to digitize patient records.Developing
- MindsetEngage with healthcare providers and interdisciplinary teams to clarify clinical documentation and resolve coding discrepancies.Developing
Wage Data According to the Bureau of Labor Statistics
Annual wage data for Medical Records Specialists (2024)
Estimated Total Employment (U.S.)
187,910
Wage Distribution by Percentile
| Metric | U.S. |
|---|---|
| 10% of workers earn the following or less | $35,780 |
| 10% of workers earn the following or more | $80,950 |
| Workers on average earn | $55,970 |
+ indicates wage is at or above the BLS reporting cap ($239,200/year)
Tools & Technology
Equipment and software commonly used in this occupation
In-Demand Technology
Frequently requested by employers in job postings
Epic SystemsHenry Schein DentrixIBM SPSS StatisticsMEDITECH softwareMicrosoft AccessMicrosoft DynamicsMicrosoft ExcelMicrosoft Office softwareMicrosoft OutlookMicrosoft PowerPointMicrosoft ProjectMicrosoft SQL ServerMicrosoft SQL Server Reporting Services SSRSMicrosoft SharePointMicrosoft VisioMicrosoft Visual BasicMicrosoft WindowsMicrosoft WordRSASStructured query language SQLTableauTeradata DatabaseeClinicalWorks EHR software
Technology Skills
3M EncoderAllscripts EHRAmazing ChartsAmerican Medical Association CodeManagerAzalea Health Azalea EHRBilling softwareCoding database softwareComChart EMR
Tools & Equipment
10-key calculatorsBarcode attachment equipmentBarcode scannersCredit card processing machinesDesktop computersDictaphonesEncodersFlat-top scanners