Quick overview
Job description
Perform daily abstraction of Trauma cases into the Trauma registry database.
Reviews Trauma admission records for identification of population.
Analyzes all records for quality assurance trauma standards recommended by governing bodies and as stipulated by regulatory group.
Performs the abstraction, coding utilizing the ICD and AIS coding required and application of all trauma data points in the registry taken primarily from inpatient trauma cases but to also include facility criteria.
Apprises Program coordinator/ Trauma Program Manager of all relevant trauma audit filter inconsistencies via periodic quality assurance reports and through the abstracting process. Produces various other quality assurance reports as directed.
Reviews patient care plans/ records for events that fail audit filters and medical quality improvement indicators or otherwise indicate a need for a review or corrective action.
Maintain a log to document the abstraction of all records.
Compiles monthly reports and summarizes statistical information for designated groups.
Participates in planning and execution of research projects.
Assists with problem solving department and organizational issues.
Enter follow up and/or update information from Autopsy reports obtained after the completion of an abstract.
Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
Must have 5 years of trauma registry experience, ATS trauma registrar course completion certificate, AIS 2015 course completion certificate, ICD 10 course completion certificate within the last 5 years, ACS level I trauma experience.
Preferred CSTR or CAISS, medical experience (RN, EMT, PT ...).
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