Trauma Registrar

Virginia Commonwealth University Health; United States; On-site; USD 34,000 - 53,000; Full time

Job summary

Virginia Commonwealth University Health seeks a Trauma Registrar to support adult or pediatric trauma programs and verification requirements for Level 1 designation. You will abstract data from EMR and prehospital databases, assign ICD-10 codes, and maintain the registry with accuracy for state and national reporting.

Required proficiency in MS Office and medical terminology; preferred CAISS/CARESS certification pathways. Evening/weekend coverage may be needed based on case volumes and surveys.

Qualifications

• Proficiency with MS Office including email, MS Word and MS Excel.
• Associate degree in medical terminology and Anatomy/Physiology or medical records coding.
• Completion of ICD-10 coding courses (preferred).

Responsibilities

• Perform daily chart reviews for selected patients and enter data into the registry.
• Assign ICD-10 and other specialized codes to procedures, comorbidities and complications.
• Interpret medical information and support performance improvement efforts.
• Ensure timely reporting of data to regulatory agencies and the organization.

Skills

MS Office

MS Word

MS Excel

Medical terminology

ICD-10 coding

Education

Associate degree in medical terminology/Anatomy & Physiology or medical records coding

ICD-10 coding courses (preferred)

Tools

EMR systems

Windows-based software

Job description

The Trauma Registrar supports the VCU Health System’s adult or pediatric Trauma Programs and organizational requirements for verification as Level 1 Trauma Center by the Commonwealth of Virginia and the American College of Surgeons by maintaining a registry database. This includes identification of cases for inclusion into the registry database, abstraction of data from various sources including the electronic medical record, prehospital databases, and other data sources. The Trauma Registrar assigns ICD-10 diagnosis codes and other specialized coding (including Abbreviated Injury (AIS) Scores) to procedures, comorbidities and complications according to methodologies and coding rules. This position performs on-Going daily chart reviews on all patients and enters data into the Registry. The Trauma Registrar reports complications and quality issues to the Supervisor. The Trauma Registrar ensures adherence to data management protocols set forth to ensure accurate and timely reporting of data to the organization and regulatory agencies. The Trauma Registrar assists with performance improvement activities.

Licensure, Certification, or Registration Requirements for Hire

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification, or Registered Health Information Technician (RHIT) preferred

Licensure, Certification, or Registration Requirements for continued employment

Certification by the Association for the Advancement of Automotive Medicine as an Abbreviated Injury Scale Specialist (CAISS) within 24 months of hire is required for Trauma Registrars, Incumbents not involved in direct patient care may continue to work while awaiting test results for up to 45 days, post 24/18 month requirement

Experience (Required)

• Proficiency with MS Office software including email, MS-Word, and MS-Excel

Experience (Preferred)

• 1 or more years of experience in medical data abstracting/coding
• Experience in trauma or surgery registry abstraction/coding depending on job assignment
• Expert skills using Windows-based software (word processing, spreadsheet, databases)
• Abstracting experience using current requirements by state and national regulatory bodies
• Experience with medical terminology and acronyms related to diagnosis, procedures, complications and comorbid conditions
• Experience with accurate and timely data entry and verification to maintain high standards of data quality control

Education/Training (Required)

• Associate’s Degree in any field that includes two semesters of medical terminology and Anatomy/Physiology, or in medical records coding from an accredited program

Education/Training (Preferred)

• Completion of ICD-10 coding courses

Independent action(s) required

Performs daily chart reviews on specific patients.

Assigns ICD-10 and other specialized codes and enters data into the registry.

Interprets medical information.

The Registrar is assigned patients of basic to moderate complexity including patients with multiple complications, including deaths.

Supervisory responsibilities (if applicable): N/A

Additional position requirements: Must be willing and able to work evenings and weekends when necessary based on case volumes and state/national verification site surveys.

Age Specific groups served: N/A

Physical Requirements (includes use of assistance devices as appropriate)

• Physical Lifting less than 20 lbs.
• Activities: Prolonged sitting, Repetitive motion Keyboarding, Mouse
• Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
• Emotional: Fast pace environment, Steady pace, Able to adapt to frequent change

Compensation Range $25.03 - $38.79 Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.

Days EEO Employer/Disabled/Protected Veteran

Who We Are

Inventing better care, day by day by discovery Sound outrageous? It absolutely is. Sound impossible? That’s never stopped us before. Sound like hard work, intense research, collaboration with experts around the world, sheer brainpower meets unrelenting willpower? That’s. Exactly. Right. We’ll do whatever it takes to offer the best in care and empower the best in quality of life. And it’s an approach that works - whether it’s a patient who undergoes a new, life-saving procedure or a clinical researcher who finds promise in a new cancer treatment, exciting new medicine is happening at VCU Health.

We have it all

• One college and four health sciences schools
• An academic medical center
• One Level I trauma center
• One of only two NCI-designated cancer centers in Virginia
• The region’s only full-service children’s hospital
• More than 800 physicians in 200 specialties
• With a community health center, dedicated research teams, facilities and valued partners in every field

Our medical teams are top notch. And we’re not too shy to boast of internationally known physicians, some recognized as the best in the country, top-ranked local specialists and all-around all-stars at every level. From our very first years to our most recent advancements, we are driven to learn more, dig deeper, teach passionately and never rest in order to be a true leader in discovering what’s possible in health and recovery. We are a comprehensive system of care and a pioneer of health. Read VCU Health Year In Review for more about our accomplishments.