Trauma Program Registrar

Job Description Summary

Responsible for aspects of the Trauma Registry to include data abstraction, data entry, ICD and AIS coding, report generation and all state, and national downloads.

• Option available to work remote in this role, but must live in MA
• May be asked to attend in-person team meetings from time to time.(Salary Range : $20.00-$30.00 / hr)

Job Description

Essential Functions

1. Extrapolate, correlate and interpret all aspects of trauma patient care from medical records and trauma registry.

a. Maintains current accurate data within the trauma registry by collecting, entering, retrieving and reporting data related to all trauma patients and data completion of the trauma patient population.

b. Exhibits proficiency in data management and aggregation and analysis.

c. Analyzes statistical data; file data; prepare reports and summaries; understand and carry out oral and / or written instructions.

d. Responsible for data submission / distribution / report generation to / for the appropriate parties within the designated time frame.

e. Uses charts, medical records and other department’s databases to identify procedural or treatment complications.

f. Reviews / manages ICD and AIS coding, report generation and all state, and national downloads.

g. Identifies when ICD 10 codes in coding summaries are incorrect and supply correct code for trauma registry reporting.

2. Abstracts all pertinent patient information required by the registry including but not limited to, demographics, pre-hospital, ED, inpatient, diagnoses, co-morbidities, complications and procedures.

3. Assures all registry data is complete and accurate prior to submitting to supervisor for review and final submission of reports to required regulatory agencies.

4. Supports the Trauma Program to ensure Level 2 Trauma Verification by the American College of Surgeons Committee on Trauma is maintained.

a. Determine appropriate ICD-10 codes for injuries and procedures.

5. Serves as the subject matter expert for the registries assigned and ensures each project is in compliance with registry standards and specifications.

6. Conducts Joint Commission on the Accreditation of Hospital Organizations (JCAHO) and American College of Surgeons (ACS) mandated audits of files.

7. Completes 80% of trauma records within 60 days of patient discharge.

8. Participates in State trauma activities, meetings and conferences at the request of the Trauma Program Manager.

Essential Functions (Cont.)

I. Technology and Learning

a. Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization.

b. Embraces technological advances that allow us to communicate information effectively and efficiently based on role.

Demonstrates strong analytical skills; strong communication skills; excellent interpersonal skills; excellent organizational skills with the ability to prioritize requests and assignments. Self-directed with initiative to function independently as needed. Self-directed with initiative to function independently as needed. Manages and prioritizes multiple tasks during periods of intense activity and work with minimum supervision. Maintains confidentiality relevant to sensitive information.

Minimum Education - Preferred

Level of knowledge equivalent to that ordinarily acquired through completion of an Associate’s Degree in Health Information Technology or Nursing preferred.

Minimum Work Experience

Minimum of two years experience in Health Information or Nursing.