SECTION 1: Job Summary (Summary of the basic functions of the position) Supports the diagnostic evaluation of tissue by histological procedures. Performs histological dutieswithin the guidelines established by histology and Moh's laboratory (clinic or stand-alone laboratory).SECTION 2: Mohs Lab Duties and Responsibilities (Responsibilities necessary to accomplish job functions) Performs a variety of specialized histopathological procedures. High Complexity Testing includes: Receiving fresh unfixed specimen at time of tissue removal, mapping, grossing, sectioning of specimen, ink application, relax cuts and scoring of tissue as needed. NON High Complexity Testing includes: Embedding, cryotomy, staining and coverslipping. Immunohistochemistry staining(in facilities that offer this service).HIGH COMPLEXITY TESTING:Specimen Collection/Triage: Receive surgical laboratory samples from patient(s) for testing. Verify correct specimen orientation for mapping. Verify patient map information: Name, accession number, stage, tumor location and diagnosis. Specimen preparation: Maintain accurate specimen identification / orientation. Divide specimen into sections for processing as noted on map. Apply color coded ink to specimen as designated on map for margin orientation. Perform relax cuts and scores to tissue specimen(s) as needed. Place specimen on embedding slide(s) for processing. (verify accession # / piece / stage).NON-HIGH COMPLEXITY TESTING:Embedding: Orient specimen correctly on a glass slide using the "reverse slide mount method" for embedding (routinely epidermis to the left). Freeze specimen to glass slide, ensuring that the epidermis / base of specimen are properly placed to ensure a complete representative section. Once frozen, invert specimen onto prepared object holder disc. Microtomy (Cutting): Operate a microtome within cryostat with correct settings, alignments and knife angles to insure optimum cutting / sectioning of specimen. Verify block orientation for proper facing of specimen. Adequately trim specimen(s) block to correct level of completeness to provide a true first margin of the specimen. (trimming excessively may generate false positive). Ability to determine and produce acceptable quality representative specimen sections. Accurately places a series of sections on a microscopic slide (labeled with accession # /piece / stage). Correctly labels and stores cut specimen blocks within the cryostat chamber to ensure accurate tissue identification. Routine Staining Procedures: Selects appropriate stains and chemicals to perform H&E or TBlue staining procedures. Prepares and maintains stains and other solutions required in staining. Demonstrate the ability to determine acceptable and unacceptable staining. Identifies and correct problem areas that result in inadequate staining. Mounting Procedure: Slides are hand cover slipped using a xylene compatible mounting medium. Specimens to be submitted for Permanent Paraffin processing: Prepare routine excisions to be processed as a "Slow Mohs" - non frozen tissue. Thaw and submit previously U.S. Dermatology Partners of Tyler frozen section (excision and biopsy) tissue for permanent paraffin processing. Prepare DAF (previously frozen) specimens to be sent for permanent paraffin processing. Instrumentation: Maintains/services instruments according to established protocols. Demonstrate the ability to operate or use instruments for intended purpose. Monitors and documents instrument performance and checks/recognizes malfunctions and identifies the need of repair. Reagent Preparation: Prepares reagents according to established procedures. Records quality control data for each reagent. Select proper storage and preservation for all reagents. Recognizes reagent malfunction and need to replace reagent. General Safety: Demonstrates correct safety practices as defined in established protocol. Recognizes and corrects dangerous situations related to job safety. Investigates and resolves complaints, or refers unusual problems to superior. Adhere to all OSHA regulations and universal precautions. Chemical Hygiene/Biohazard Procedures: Demonstrate proper handling of chemicals and biohazard materials. Adheres to all OSHA regulations and universal precautions, including waste and sharps disposal. Maintains knowledge of OSHA regulations and use of universal precautions as appropriate. General: Participate in department or unit Quality Improvement activities. Assist in general housekeeping duties for Mohs Laboratory, including weekly "scrub down". Maintain Mohs & DAF laboratory log books (accession / date / patient / tumor location).Assists in the evaluation of new procedures and equipment for possible adoption by the laboratory environment. Conducts quality control procedures on equipment, reagent, and products and maintains proper records for quality control reports. Prepares slides with permanent labels and files appropriately. Maintains Mohs/Excision logbooks. Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service. Performs other duties that may be necessary or in the best interest of the organization. Pathology Lab Duties and Responsibilities(Responsibilities necessary to accomplish job functions) Performs a variety of specialized, difficult, delicate and complex chemical, histopathological or immunologic procedures in identifying specific components. High Complexity Testing includes: Grossing. (This would consist of specimens received in the lab that are fixed in 10% formalin, and specimens submitted in Michel's Fixative for Immunofluorescence processing)NON High Complexity Testing: All other lab procedures. High Complexity Testing includes: Grossing and nail processing. This would consist of specimens received in the lab that are fixed in 10% formalin, and specimens submitted in Michel's Fixative for Immunofluorescence processing. Gross Exam: Maintains accurate specimen identification. Measures specimens Select the right tissue cassettes for processing and store residual tissues. Records information to be used during embedding and cutting. Nail Processing and Decalcification: Select appropriate specimens for decal procedure. Use of Sodium Hydroxide for nail specimen. Determine appropriate degree of decalcification. NON-HIGH COMPLEXITY TESTING:Specimen Collection/Triage: Receives, accepts and recognizes specimens that arrive in the laboratory. Check for proper identification and fixative. Accession specimen with proper patient information. Tissue Processing: Implement appropriate procedure during processing. Prepares and maintains tissue processor Tissue Embedding: Recognizes adequacy of processing. Determines correct mold size for the specimen. Maintains accurate identification of the specimen. Identifies and orients specimen correctly Microtomy (Cutting): Operates a microtome with correct settings, alignments and knife angles to insure optimum sectioning. Determine block orientation and facing in order to obtain a full representative section. Ability to determine acceptable sections. Selects correct procedure regarding section thickness. Select appropriate slides for specific stain. Maintains accurate tissue identification. Routine Staining Procedures: Selects appropriate stains and chemicals to perform H & E staining procedures. Prepares and maintains stains and other solutions required in staining. Demonstrate the ability to determine acceptable and unacceptable staining. Identifies and correct problem areas that result in inadequate staining. Mounting Procedure: Select correct mounting medium for each type stain. Special Stain Techniques: Identifies proper control and stains to be used for demonstrating specific tissue constituents and pathogens. Demonstrate the ability to determine acceptable vs. unacceptable staining. Identifies and corrects problems that result in inadequate or improperly stained tissue. Immunohistochemical Techniques: Identifies the proper control for Immunohistochemistry and Immunofluorescence to be used for specific antibodies. Determines appropriate antigen retrieval procedure for each antibody. Instrumentation: Maintains/services instruments according to established protocols. Demonstrate the ability to operate or use instruments for intended purpose. Monitors and documents instrument performance and checks/recognizes malfunctions and identifies the need of repair. Reagent Preparation: Prepares reagents according to established procedures. Records quality control data for each reagent. Select proper storage and preservation for all reagents. Recognizes reagent malfunction and need to replace reagent General Safety: Demonstrates correct safety practices as defined in established protocol. Recognizes and corrects dangerous situations related to job safety. Adhere to all OSHA regulations and universal precautions. Chemical Hygiene/Biohazard Procedures: Demonstrate proper handling of chemicals and biohazard materials. Maintains knowledge of OSHA regulations and use of universal precaution Assists in the evaluation of new procedures and equipment for possible adoption by the laboratory environment. Conducts quality control procedures on equipment, reagent, and products and maintains proper records for quality control reports. Prepares slides with permanent labels and files appropriately. Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service. Performs other duties that may be necessary or in the best interest of the organization. SECTION 3: Experience Requirements Minimum one year of work experience in a medical office, required. SECTION 4: Knowledge, Skills and Abilities Requirements Thorough knowledge of medical terminology, required. Basic knowledge of medical billing coding, including CPT and ICD-10 coding, required Detail oriented, professional attitude, reliable Management and organizational skills to support the leadership of this function Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations Interpersonal skills to support customer service, functional, and team mate support needs Able to communicate effectively in English, both verbally and in writing Mathematical and/or analytical ability for basic to intermediate problem solving Basic to intermediate computer operation Proficiency with Microsoft Excel, Word, and Outlook Specialty knowledge of systems relating to job function Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelinesSECTION 5: Supervisory Responsibilities: This position has no supervisory responsibilities
