Functional Statement
Medical Records Administrative Specialist
Cancer Registrar
GS 8
I.
Introduction
Location: Position is located in the Hematology-Oncology Department of the
MVAC at the Buffalo VAMC.
Reports To: The Cancer Registry Coordinator reports to Cancer Committee and Chief
of Oncology.
II.
General Description
The Cancer Registrar/Coordinator is responsible for the professional and Administrative
management of a registry in a relatively large and complex medical center and research
program affiliated with a medical school. The work of the position supports the care and
treatment given to patients with malignant conditions.
The incumbent in this position is responsible for developing, implementing, planning,
organizing, actuating, and control of all activities in the Oncology Cancer Registry
program. The Cancer Registry Coordinator, in conjunction with the Chief of Oncology,
coordinates all activities associated with the cancer program at this VA facility.
Incumbent is responsible for providing advisory and technical service to administrative,
medical, and ancillary professional staff as it relates to the integration of the Cancer
Committee policy and procedures, the accreditation standards of the American College
of Surgeons Commission on Cancer Program, the VA Oncology Program and the
National Cancer Institute’s SEER Program, and the American Joint Committee on
Cancer. Incumbent makes recommendations for program changes to the Cancer
Committee, the Cancer Committee Chairperson, and the Cancer Liaison to the American
College of Surgeons. Incumbent is an integral part of the Cancer Program at this
Medical Center.
III.
Functions:
A. Casefinding
Incumbent is responsible for developing, implementing and maintaining accurate
cancer Casefinding to identify all reportable diagnoses in accordance with the American
College of Surgeons Commission on Cancer , the VA National Oncology Program and
the individual facility. The incumbent utilizes the VISTA Oncology Software and CPRS
software. The incumbent thoroughly reviews reports to evaluate clinical and diagnostic
procedures to assess appropriateness of inclusion in the registry.
B. Abstracts, Codes and Maintains Registry Records
Thoroughly searches the medical record to identify and code all information pertinent to the
patient's diagnosis. This includes demographics, diagnosis, site and histology, diagnostic
procedures, extent of disease, and treatment. Coding assignments may involve highly technical,
complex diagnoses/procedures. Utilizes coding references to ensure that complete and accurate
data is collected. Codes information contained on several forms and documents that make up
an entire record. Codes diseases, surgical procedures, and causes of injury. In addition uses
specific codes required in a cancer registry, stage of disease, morphology, and topography using
International Classification of Diseases for Oncology (ICDO), AJCC Staging Manual and the
(Registry Operations and Data Standards (ROADS) Manual. Independently codes a wide variety
of medical diagnostic, therapeutic, and surgical procedures. Codes diseases and causes of injury.
Codes stages of disease using International Classification of Diseases for Oncology. Analyzes
the consistency of coding of registry data, cancer diagnosis, histology, treatment (including
surgical procedures, chemotherapy, immunotherapy, hormonal therapy and radiation therapy.)
Identifies coding discrepancies. Facilitates resolution of coding discrepancies by discussion with
providers/registry coordinator. Codes complicated medical records having diagnostic, surgical
and therapeutic procedures that are identified as difficult to classify.
Employee aids in a wide range of quality assurance studies, codes complicated medical records
that are difficult to classify, or makes recommendations to improve procedures for compiling,
retrieving, and reporting medical record information. Applies an extensive knowledge of legal
and regulatory requirements governing medical record operations to provide problem-solving
services in specific medical record functions and in research activities as related to an Approved
Cancer Program to plan, organize, and maintain special cancer registries.
Reviews records to obtain data. Enters data obtained from the record into the registry software.
Analyzes data retrieved and provides the results to health care staff for research, patient care,
protocol studies, and trends in cancer. Submits data annually to the VA Central Cancer Registry,
per directives. Submits data to the American College of Surgeons’ National Cancer Database
annually. Data includes codes for diagnoses and procedures, topography, morphology, and stage
of disease, provider information and coded data for the treatment of cancer. Collects core data
from patients’ records, including demographic characteristics, diagnostic procedures, diagnoses,
stage and extent of disease. Ensures that data is reported accurately and in correct format.
Devises format for some information, to meet requirements established by requestor. Prepares
correspondence and summaries of medical records in response to a variety of requests.
Performs research and prepares correspondence by retrieving and releasing data following
a standardized approach that meets the requirements of the Privacy Act and Freedom of
Information Act regulations. The employee validates data gathered for various sources.
Maintains health record indexes and compiles administrative and health statistics for physicians
as well as all other health care staff at this facility and throughout the VA System as well as
public health officials, medical center management, planners, and others.
Organizes and maintains a data system which conforms to the standards of an Approved Cancer
Program and meets the needs of the users of the registry data. Maintains quality control of followup procedures.
Sets up plans to ensure the continuous review by professional staff to assure quality of services as
required for an Approved Cancer Program. Researches program and operations documentation
and standards. Applies established quality assurance methods and techniques to update or make
revisions to existing processes. Assists in data extraction and analysis where needed. Serves as
the subject matter expert on registry issues for the facility and VISN administrations. Performs
other related duties as assigned.
C. Quality Control – Develops and Monitors Quality Management and Improvement,
Performance Projects and Special Studies to Enhance Cancer Patient Care and to meet
Requirements of the Commission on Cancer
Monitors cancer committee processes and procedures implemented to improve patient care
and to verify compliance of plans and requirements. Provides technical advice to the clinical
staff relative to the best method of recording AJCC Staging, the use of staging forms, and the
correct documentation of diagnoses/procedures. Consults with the appropriate physician or
other clinician(s) for clarification when conflicting information appears in the medical record.
Provides administrative guidance and advice to staff regarding methods of proper medical record
documentation. Performs analysis of work processes or service delivery practices to identify
reasonable and efficient measurement of the quality of the work or the activity and to identify
areas of possible improvement. Performs the quantitative and qualitative analysis on medical
records to ensure that all component parts are present, accurate, complete, timely and will meet
the established requirements and standards of JCAHO and the American College of Surgeons.
Conducts special studies and surveys for identifying opportunities to improve patient care.
As part of the formal Medical Record Review process under the direction of the Quality
Improvement Program, participates in routine and focused reviews for the purpose of identifying
problems and potential problems in record documentation. Participates in activities to gather
information for time studies or quality assurance studies for assessing and improving cancer
patient diagnoses, treatment and quality of life issues. Identifies steps of simple processes
and routine practices that might be opportunities for applying standard quality improvement
techniques. Gathers information through local as well as national American College of Surgeons’
annual Patient Care Evaluation Studies in order to identify potential for significant quality
process improvement.
D. Cancer Committee
Incumbent coordinates the activities of the cancer committee and is an active member
of the committee and maintains and reports minutes of these meetings. Assists in the
reporting of the committee and cancer program activities to the Medical Staff Executive
Committee.
Coordinates activities of the cancer registry with those of the cancer committee in
developing criteria for patient care evaluations. Conducts short term and long term
audits as required or requested. Reports cancer registry activities to the committee on a
regular basis.
Educates the cancer committee, medical staff and administration on the standards
and survey process of the American College of Surgeons Commission on Cancer.
Organizes and supervises the survey process, preparation and participation in the
survey and pre-survey consultation.
The incumbent coordinates, oversees and facilitates the Cancer Committee meetings to
monitor compliance with ACoS standards to ensure certification of the Cancer Program.
This includes preparing meeting agendas in collaboration with the Cancer Committee
Chairperson, and preparing and disseminating minutes from the meetings.
Incumbent prepares and presents outside study requests to the IRB in accordance with
VA policies and procedures.
E. Cancer Registry Administrative Management
The incumbent is responsible for developing, maintaining, annual review and updating a
Cancer Registry Policy and Procedure Manual in accordance with VA policy and ACoS
requirements.
He/She organizes and maintains a data system which conforms to the standards of an
Approved Cancer Program and meets the needs of the users of the registry.
Independently maintains a registry that is continuously prepared for a Commission
on Cancer survey, to include the necessary documentation needed for the surveyor’s
review. This includes, but is not limited to Tumor Board/Cancer Conference
documentation, Cancer Committee minutes, and the registry procedure manual.
The incumbent is responsible for identifying patients who are potential candidates
for clinical trials sponsored by the NCI, cooperative groups such as CALGB and inhouse trials. The individual must notify the Oncology attendings and Clinical Research
Associate on a set schedule at the time of identification of these patients. This includes
assistance in case review including diagnostic work-up and staging.
The incumbent is responsible for assisting physicians and nurses with research studies
requiring cancer registry information. This aspect of the incumbent’s duties may
require the review of medical records for additional information, analysis of data, and
preparation of written summaries of information required by the requestor.
Performs quality assurance activities to ensure completeness and accuracy and followup with data sources necessary and reports these activities to the cancer committee.
Acts as a liaison between the cancer committee and the VA National Cancer Registry,
the ACoS and the New York State Cancer Registry.
Educates and provides staff support to physicians, nurses and other clinical and clerical
staff on committee functions, administrative activities, quality management studies and
registry functions and reports. Coordinates and integrates registry activities with other
departments and institutions.
Incumbent acts as the hospital ADPAC for the VISTA Oncology Package.
Maintains established departmental and hospital policies, procedures, objectives, quality
assurance, safety environmental and infection control policies and procedures.
Participates in educational activities of the hospital as well as local, state, and national
cancer registrar associations.
Acquires and maintains credentials of a Certified Cancer Registrar by the National
Cancer Registrars Association.
IV.
Knowledge Required by the Position:
Certification through the National Cancer Registrars Association and maintenance of this
certification is required. This includes, but is not limited to:
1) Possession of extensive knowledge of the Cancer Registry software
2) Knowledge of cancer registry management and staffing. To include registry
planning, organizing and operations.
3) Knowledge of medical center administrative and medical policies, procedures
and accreditation standards
4) Extensive knowledge of medical terminology, extensive anatomy & physiology,
epidemiology, specifically the relationship to neoplasms
5) Knowledge of histology as indicated in the International Classification of
Diseases for Oncology (ICDO)
6) Knowledge of IDCO and ICD-9 coding schemes
7) Knowledge of the American College of Surgeons’ Standards of the Commission
on Cancer
8) Knowledge concerning the National Cancer Institute’s SEER Program
9) Knowledge concerning the AJCC Cancer Staging Manual
10) Knowledge and mathematical skills to develop his/her own statistical data
collection forms and statistical graphics as may be required when reporting
11) An extensive knowledge of medical records procedures, regulations, and
principles to carry out a variety of medical records functions such as analysis,
coding, abstracting, quality assurance, reporting, release of information, and
compiling data
12) Knowledge of general functions of other services, such as pathology, radiology
and radiation therapy, in order to obtain critical information necessary for current
status of patient’s cancer status, such as primary or metastatic disease and
treatment.
In addition, the following requirements are essential:
1) Computer knowledge to enable incumbent to complete data items in the
2)
3)
4)
5)
V.
Oncology Program. Knowledge of Microsoft, including WORD, Excel, Outlook,
Internet Explorer and other program features within Microsoft in order to
complete reports, graphs for statistics and correspondence.
Organizational skills in order to maintain a registry that is continuously prepared
for ACoS survey, to include the necessary documentation needed for the
surveyor’s review.
Knowledge of the provisions of the Privacy Act, Freedom of Information Act and
HIPPA.
Excellent judgment and diplomacy to contact professionals, administrative staff,
patients, other registrar personnel and co-workers on the goal toward maintaining
accreditation through the Commission on Cancer
Continues educational knowledge of revisions to the required data set and other
requirements for the Cancer Program through the use of conferences, workshops
and other media sources.
Supervisory Control
The cancer registry coordinator is responsible to the Chair of the Cancer Committee/
Chief Oncology. The Cancer Registry Coordinator, according to the guidelines of the
ACoS Commission on Cancer’s standards carries out the Oncology Patient Registry
operations duties and responsibilities independently. Work problems are normally
resolved by the Cancer Registry Coordinator without reference to the supervisor,
in accordance with policies, procedures, knowledge of the medical record field,
consultation with other Cancer Program Specialists, and previous training. The Cancer
Committee oversees the registry and reviews the registry operations for completeness
and accuracy as required by the Commission on Cancer.
The Cancer Registry Coordinator must provide leadership, direction and documentation
necessary for the coordination of the oncology patient registry activities involving various
levels of staff.