Clinical Data Abstractor

Job Description

Under the supervision of the manager, using established policies and procedures, performs concurrent and retrospective data abstraction for Cardiac Cath and Percutaneous Coronary Interventional procedures. The ACC data Specialist ensures accuracy and quality of data collected and exports into the electronic data collection system and reviews inaccuracies with physicians. The Clinical Charge specialist is responsible for administration and management of all components of the charging process including continuing maintenance of the current systems, development of new processes, education of department associates, and coordinating efforts with other departments to ensure accuracy and integrity of this entity. The care is culturally based and age specific. .

Responsibilities

General Charge Specialist Duties

1.) Maintain and update all functions related to procedural coding

2.) Ensures accurate and timely updated to the Merge system. Run accurate and timely reports utilizing UDR system.

3.) Coordinates communication with Chargemaster Services to verify any changes made to the inventory and procedural charging

4.) Knowledgeable to all coding changes that could impact revenue and or billing.

5.) Knowledge and training in multiple computer systems (i.e. EPIC, Microsoft office, MIDAS, Excel, Outlook)

6.) Current knowledge of rules, regulations, policies, and procedures related to third party payers, JC, CMS, and other regulatory agencies.

General ACC Data Specialist Duties

1.) Conducts medical record reviews and abstraction for designated core measure data

2.) Ensures complete data collection (both paper and EMR) and entry into an electronic database.

3.) Participates in the analysis and evaluation of collected data.

4.) Functions as resource in formulating action plans related to findings.

5.) Maintains accuracy, integrity, and reliability of the data to support the National Cardiovascular data Registry (NCDR) process.

6.) As assigned, functions as support to medical staff committees (peer review), interdisciplinary QI/PI teams, and hospital departments by performing the following activities:

a. Works with committee Chairpersons in developing the agenda, the charter, and outlining the responsibilities of each of the committee members.

b. Collects appropriate quality performance data and clinical information for ACC cardiac cath and PCI registry.

c. Analyzes and evaluates data and clinical information to identify quality issues and trends.

Maintenance of Daily Charges

1.) Ensure daily audit of all procedures completed in the cath lab, angiography, and CVRU.

2.) Make appropriate adjustments to patient's procedural charges after reviewing the daily charges

3.) Conducts and tracks staff procedural recording errors and ensures that the corrected procedure chart is in patient's medical record.

4.) Review RMS reports to verify that all charges were accepted completely and accurately by the charge capture system.

5.) Collaborates with all inventory system including PAR-X to ensure accurate inventory, hospital pricing and charging to patients.

Department Projects

1.) Assist in the creation and support of existing and new department projects to continually strive to improve current processes.

2.) Develop at least one performance improvement project annually.

3.) Assumes responsibility of accurate and data collection for specific reports and ensuring their distribution to the appropriate areas ie: radiation coverage and dosage.

4.) Responsible for abstracting any and all clinical data requested of management and physicians from any electronic data collection system with the interpretation and presentation of conclusions via chart, graph, or spreadsheet format.

Leadership - Demonstrates leadership skills such as the ability to motivate, educate, delegate, and mentor peers and other members of the healthcare team while effectively managing the care of patients and family members.

Acts as a resource and educator for multidisciplinary team members and students, continuously evaluating and documenting competency.

Professional Development - Assumes responsibility and accountability for professional growth and development. Contributes to the professional development of peers, colleagues and others.

1) Participates in 75% of staff meetings and 75% of council meetings as appropriate. Participates in council activities and task forces to improve competencies of self, co-workers, and staff members related to patient care.

2) Supports self and peers in professional growth and development utilizing resources and opportunities within and outside of The Christ Hospital. Acts as a resource, educator and preceptor for staff and nursing students.

3) Completes all educational requirements to maintain competency related to specific population of patient and/or regulatory agencies (Healthstream education 100% on-time completion and attendance for annual education day). Submits required tests and paperwork in a timely manner without management interventions.

4) Participates in self and peer review activities to include the positive recognition of peers and staff on a regular basis.

5) Prepares for certification specific to work area of professional practice when eligible.

6) Participation in chosen professional organizations, conferences and research is encouraged.

7) Participates in performance improvement initiatives.

8) Participation in community service activities is encouraged.

9) Participation in research activities is encouraged.

Productivity - Understands factors related to cost and effective outcomes when planning and implementing patient care.

1) Manages workload effectively.

2) Understands and maintains awareness of fiscal responsibility by utilizing staff, time, equipment, and supplies appropriately.

UNIT POPULATION SERVED COMPETENCY

Evidence exists that The Christ Hospital staff considers the special needs and behaviors of the specific patient populations served, associates demonstrate those competencies that address the unique characteristics related to developmental, physical, psychosocial, mental, emotional, and social needs of patients across the life span. Employees are able to demonstrate those competencies that address the needs of patients with unique cultural norms, religious preferences, language, communication barriers, literacy issues, and health literacy limitations.

Qualifications

KNOWLEDGE AND SKILL:

Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not list personal credentials of the current jobholder that would not be required if the job were being filled. List any special education required for this position.

EDUCATION:

• TCH does hire AD and Diploma nurses; however

• TCH requires that all nurses hired after January 2010 receive their BSN within 5 years of the date of hire.

• RN's who were employed at TCH prior to January 2010, are required to obtain a BSN by December 31, 2020.

• A MSN or DNP are not required but supersede the requirement for the BSN.

• Radiology Technologist/CVT with knowledge of radiology and cardiac procedures

YEARS OF EXPERIENCE: 5 years

REQUIRED SKILLS AND KNOWLEDGE: The RN/Radiology Technologist//CVT demonstrates the knowledge, abilities, and skills to provide age and culturally specific patient care and education. The RN/Radiology technologist effectively communicates with peers, utilizes appropriate channels of communication and maintains absolute confidentiality. The RN/Radiology technologist maintains competence and demonstrates evidence of continuing professional growth. The RN/Radiology technologist demonstrates the ability to accept and implement change and the ability to work in a culturally diverse setting. Good understanding of cardiovascular and peripheral anatomy, ability to communicate changes to associates related to charge codes, database skills to effectively track trends in both the cardiac and peripheral areas.

LICENSES & CERTIFICATIONS:

The RN holds a current licensure to practice nursing in Ohio. Membership in professional organizations is desirable. BLS certification is required prior to patient contact. Certification in area of clinical specialty is expected within five years of eligibility. The Radiology technologist holds a current licensure to practice as radiology technologist in Ohio

About Us

For more than 130 years, The Christ Hospital been the beacon for exceptional healthcare in the Greater Cincinnati community. We're industry pioneers, always pushing the boundaries and reimagining the future of healthcare.



Our culture promotes collaboration, diversity and innovation. Together, as a team, we work tirelessly to enhance healthcare quality, accessibility and safety.