Senior Vascular Surgery Professional Coder (CPC, CCS-P, CIRCC)
hace 14 días
Clifton
Job Description New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior authorization and medical necessity review processes for vascular and interventional procedures. The ideal candidate possesses advanced knowledge of: • Vascular surgery coding, • Endovascular intervention coding, • Interventional Radiology coding, • Catheterization hierarchies, • Radiology supervision & interpretation (S&I), • Global surgery rules, • NCCI edits, • Modifier usage, • Payer authorization requirements, • Medicare/commercial payer policies This position requires independent review and coding of highly complex operative reports and procedural documentation across hospital, ASC, office, and interventional settings. Senior Vascular Surgery Professional Coder Core Responsibilities: Professional Coding Responsibilities • Review and accurately code complex vascular surgery operative reports, procedure notes, and E&M encounters, • Assign CPT, HCPCS, ICD-10-CM, and modifiers in accordance with AMA, CMS, NCCI, and payer-specific guidelines, • Interpret and code:, • open vascular procedures,, • endovascular interventions,, • angiography,, • catheter placements,, • thrombectomy,, • bypass grafting,, • dialysis access procedures,, • embolization,, • stent placement,, • EVAR/TEVAR,, • and hybrid vascular procedures, • Apply correct selective catheterization hierarchies and vascular family rules, • Code radiology S&I services appropriately, • Review operative documentation for completeness and compliance, • Query providers for clarification when documentation is insufficient, • Identify coding opportunities, missed charges, and undercoding trends, • Resolve coding edits and claim rejections related to vascular procedures, • Support denial management and payer audit responses, • Maintain productivity and accuracy standards for high-complexity vascular coding, • Collaborate with physicians, billers, auditors, and revenue cycle leadership, • Stay current on annual CPT, CMS, and payer policy updates impacting vascular surgery Prior Authorization & Medical Necessity Responsibilities: • Obtain and manage prior authorizations for vascular surgery, endovascular, imaging, and interventional procedures, • Verify medical necessity requirements based on payer policies and LCD/NCD guidelines, • Submit supporting clinical documentation for authorization requests, • Track authorization status and ensure approvals are obtained prior to scheduled procedures, • Communicate authorization requirements and updates to providers, schedulers, and clinical staff, • Assist with peer-to-peer coordination and payer follow-up when necessary, • Review denials related to authorization or medical necessity and support appeal preparation, • Maintain accurate authorization documentation within the EHR and billing systems Senior Vascular Surgery Professional Coder Required Qualifications: • Minimum 3–5 years of dedicated vascular surgery coding experience, • Extensive experience coding:, • open vascular surgery,, • interventional vascular procedures,, • angiography,, • and radiology S&I services, • Prior authorization experience within surgical or interventional specialties, • Strong understanding of:, • CPT,, • ICD-10-CM,, • HCPCS,, • NCCI edits,, • modifier usage,, • global surgery rules,, • medical necessity criteria,, • and payer reimbursement methodologies, • Ability to independently interpret highly complex operative reports, • Experience with EMR/EHR and encoder software, • Strong analytical and critical thinking skills, • Excellent written and verbal communication skills Senior Vascular Surgery Professional Coder Preferred Qualifications: • CPC, CCS-P, CIRCC, or equivalent coding certification, • CCS & CIRCC strongly preferred, • Experience in vascular surgery, interventional radiology, or cardiovascular surgery specialty coding. General Surgery a plus., • Experience with Medicare and commercial payer audits, • Experience in academic or high-volume multispecialty vascular practices Preferred Experience: • Experience with:, • Aprima EHR, • Epic, • Microsoft Excel, • Familiarity with reporting, reconciliation, and spreadsheet analysis Senior Vascular Surgery Professional Coder Productivity & Performance Expectations: • Maintain high coding accuracy in a complex vascular surgery environment, • Meet established coding turnaround and lag-day expectations, • Demonstrate proficiency with:, • modifier assignment,, • procedural bundling logic,, • selective catheterization hierarchy,, • and endovascular coding guidelines, • Maintain timely authorization turnaround and documentation accuracy, • Participate in ongoing education and specialty coding updates Senior Vascular Surgery Professional Coder Ideal Candidate Profile The ideal candidate is a highly experienced vascular surgery coder capable of independently coding complex open and endovascular operative cases while also supporting prior authorization workflows, payer compliance, and revenue cycle optimization in a fast-paced specialty practice environment.
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