Grade 14 $18.81 - $24.46/hr (midpoint)
Cheyenne Regional Medical Center
High School graduate or equivalent required
The Senior Clinical Abstractor functions under supervisory oversight of the Data Management Manager. The primary purpose of this position is to abstract clinical information based on criteria specified by internal/external regulatory agencies. Entry of collected data is made into electronic clinical repository. The maintenance of repository system includes dictionary mapping and interface validation. The candidate for this position must have a meticulous approach to abstraction as well as reliability rating of >95% will be required. The Senior Clinical Abstractor is also responsible for coordination of specific data collection elements as appropriate for various clinical specialties.
1. Abstracts data to meet all Medical Staff quality indicators, OPPE requirements, and re-credentialing/advancement reports.
a. Retrieves electronic health information via multiple technologies to fully complete the abstraction process
b. Abstracts data out of each technology and enters into MIDAS+ Care Management system
c. Maintains an abstraction reliability rating greater than 95%
2. Cross trains with other Senior Clinical Abstractors to ensure abstraction coverage at all times.
3. Conducts inter-rater reliability testing with other Senior Clinical Abstractors to maintain accuracy of all data abstraction.
4. Collaborates with the Director of Medical Staff, Medical Staff members, and executive leadership to identify Medical Staff data abstraction needs.
5. Nurtures interdepartmental relationships with other support services such as Medical Staff Office, Finance, HIM, and IT.
6. Works in tandem with the Data Analyst for Medical Staff and Data Management Manager by interpreting abstracted data to be incorporated Medical Staff reports, as appropriate.
7. Communicates any missing documentation to HIM and the Medical Staff Office.
8. Identifies attribution/coding issues within the electronic health information and communicates with Patient Financial Services.
SKILLS, KNOWLEDGE, AND ABILITIES
- Ability to use basic office equipment including telephone, computer, calculator, etc
- Communicates effectively and possesses excellent customer service skills
- Ability to work independently and\or effectively as project team member
- Demonstrates sound judgment and attention to detail
- Ability to handle multiple tasks simultaneously
- Moderate level of computer literacy
- Knowledge of human anatomy, physiology, medical terminology, organization of medical records and clinical coding systems (ICD-9 and CPT )
- High school diploma or GED
- Two years experience as a licensed practical nurse or registered nurse
- Associate’s degree
- RN licensure in the State of Wyoming
- Experience in clinical abstraction or coding
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