Job Type: Per Diem

Time Type: Part time

Work Shift: Day (United States of America)

FLSA Status: Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the direction of the Trauma Program Manager, identifies all relevant patients for the Trauma registry for concurrent data abstraction. Collects, retrieves and enters all data using the Trauma Registry database. Ensures accuracy and integrity of data collected and entered.

Job Description:

POSITION DUTIES AND RESPONSIBILITIES

• Work with the Trauma Program Manager to provide accurate and up to date monthly data for all Trauma-related reporting.

• Facilitates development of a streamlined flow of data into the registry from concurrent sources.

• Informs the Trauma Program Manager and the Trauma Medical Director of any concerns regarding inaccurate data or data sources.

• Coordinate with the medical record staff to maximize efficiency in abstracting the required data elements from the medical record and other available sources.

• Consistently produces completed abstractions as well as data entry on a monthly basis no later than two months of patient discharge.

• Collaborates in a professional manner with all members of the healthcare team to promote the goals and objectives of the Trauma Program.

• Maintain inter-rater reliability accuracy of 95% or greater on chart abstractions to ensure data quality.

• Report critical gaps in the presence of medical record documentation to the Trauma Program Manager.

• Create PI reports on all trauma patients and report to various departments/agencies as needed

• Complete at least 6 hours of registry specific continuing education per year.

Professional Qualifications

• General knowledge of medical record-keeping principles and practices.

• General knowledge of medical terminology, anatomy and physiology sufficient to evaluate, abstract, and code specific diagnosis and treatment information from patient'’ medical chart.

Experience : Minimum 3 years Trauma Registry experience, LI, LII, or LIII

Certification : CSTR and/or CAISS certification preferred

Education: Two (2) years college or equivalent with additional training in medical terminology and anatomy.

Special Skills: Excellent oral and written communication skills, ability to exercise good judgement. Proficient in Microsoft Word, Access, Excel, and PowerPoint. Ability to train new and existing staff members.

Accountability: Responsible for accurate selection of diagnosis and procedures and appropriate codes; determination of correct principal diagnosis and procedure, correct ICD-9 assignment. Responsible for auditing inpatient and outpatient coding and documentation compliance.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled