Position Summary:
Performs the coding and posting of physician hospital charges on all vascular patient accounts. Coordinates coding and billing in the Vascular Special Procedures (VSP) area of the Surgical Specialties Building (SSB).

Qualifications:
Prior experience in vascular, endovascular and interventional coding, insurance, charge posting, knowledge of medical terminology and vascular anatomy is required. Professional coding and interventional coding certification preferred. 

Position Accountabilities:
Commitment to perform all job responsibilities in accordance with the philosophy and mission statement of USA. Honest, ethical, professional behavior is a condition of employment.

Coordinates all aspects of vascular/endovascular coding and billing to include ongoing education to the vascular physicians and employees, as well as training new vascular/endovascular coders.

Reviews all charge information submitted by the physician. Assigns and reports codes that are clearly and consistently supported by physician documentation in the health record. Also consults with the physician for clarification when there is conflicting or ambiguous data in the health record.

Review medical record documentation as necessary and notify physician when surgery dictation is absent.

Make modifications as needed to ensure compliance with coding/billing regulations. Maintain and enhance coding skills by keeping current with changes in ICD-9, CPT, HCPCS, Correct Coding Initiative manuals, carrier bulletins and Local Coverage Determinations (LCD’s). Also keeps physicians informed of LCD’s that restrict the billing of specific surgical procedures.

Ensure physician notification/verification on all charges, changes submitted and/or claim issues.

Acknowledge they may NOT upcode without physician verification.

Avoid instances of “code gaming,” “unbundling,” and other improper activity designed to increase reimbursement. Strives for optimal payment to which the physician is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.

Perform an annual review to update/revise the computer coding database and superbill charge forms.

Posts all vascular physician hospital charges to include operative procedures and Evaluation and Management (E&M) services into USA’s computer billing software system.

Determines proper code and diagnosis before entering into system and reviews all claims denied for ICD-9 and CPT problems or errors and assist the billing office staff with resolution of the problem.

Researches, verifies and registers all new hospital patient information into USA’s billing software system.

Enters charges into the proper charge books as needed.

Maintains a working knowledge of insurance requirements to achieve objective of furnishing prompt, accurate information to the correct payer to expedite reimbursement of maximum allowable benefits.

Review and follow-up on hospital records for pre-certification verification.

Discuss claim problems, code changes or reimbursement with physicians.

Submit claims with operative notes and other pertinent information to support claim, at time of submission.

Performs error corrections when patients’ insurance information has been changed or entered after charge has been posted.

Review Medicare and insurance denials as they relate to coding.

Performs all other duties as assigned.