The Patient Record Abstractor IV is responsible for accurately abstracting and coding clinical information from cancer patient medical records in accordance with the standards of the California Cancer Registry (CCR), SEER Program, California Cancer Surveillance Program (CSP), UCLA Cancer Registry, and the Commission on Cancer.

This position supports UCLA Health’s commitment to data integrity, regulatory compliance, and cancer surveillance, contributing to improved patient outcomes, research, and public health reporting.

Key Responsibilities

Cancer Data Abstraction & Coding

• Abstract and code clinical and pathological data from medical records using CCR, SEER, CSP, and Commission on Cancer guidelines
• Assign ICD-O codes, accession/sequence numbers, and ensure accurate data entry into the cancer registry database

Staging & Classification

• Determine and assign appropriate:
  • SEER Summary Stage
  • TNM staging for analytic cases
  • Extent of Disease (EOD)

Medical Record Review

• Review and analyze patient information in the electronic medical record (CareConnect) and paper charts as needed
• Validate clinical documentation to ensure completeness and accuracy of abstracted data

Treatment & Case Completion

• Abstract all required treatment information to ensure complete and timely case reporting
• Ensure all reportable cases are finalized in compliance with registry standards

Quality & Productivity

• Maintain a high level of accuracy (≤3% error rate) in accordance with CCR standards
• Meet or exceed established productivity benchmarks