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.
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. Avoid instances of “code gaming,” “unbundling,” and other improper activity designed to increase reimbursement.
Maintains a working knowledge of insurance requirements to achieve objective of furnishing prompt, accurate information to the correct payer
Maintains working knowledge of several hospital computer systems to obtain operative and pathology reports.
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.
Researches, verifies, and registers new patient information into USA’s billing software system.
Reviews hospital records for pre-certification verification as needed.
Reviews all hospital charge information submitted by the physician. Assigns and reports codes that are clearly and consistently supported by physician documentation in the health record.
Makes modifications to CPT, E&M, ICD-9, and modifiers as needed to ensure compliance with coding/billing regulations.
Maintains and enhances coding skills by remaining current with changes in ICD-9, CPT, HCPCS, Correct Coding Initiative Manuals, Medicare Administrative Contractor (MAC) bulletins and Local Coverage Determinations (LCD’s). Also keeps physicians informed of LCD’s that restrict the billing of specific surgical procedures.
Posts all vascular physician hospital charges to include operative procedures and Evaluation and Management (E&M) services into USA’s computer billing software system.
Consults with the physician for clarification when there is conflicting or ambiguous data in the record.
Reviews medical record documentation and notifies physician when surgery dictation is absent or missing.
Ensures physician notification/verification on all charges, changes submitted, and/or claim issues.
Maintains scanning of all charges submitted by the physicians.
Assist the billing office staff as needed for a review of reimbursement denials due to possible coding issues.
Performs all other duties as assigned.
Serving the Chattanooga Community since 1976, University Surgical Associates (USA) has grown from a two-surgeon practice to one of the largest multi-specialty surgical groups in the southeast.
Supported by more than 200 employees, USA’s 30+ surgeons and other healthcare providers take great pride in providing quality and compassionate surgical care for their patients; professional support for area physicians facing critical or complicated cases; and the training of surgeons and medical students through a comprehensive residency program.
USA serves its patients at 10 conveniently located offices in and around the greater Chattanooga region, and enjoys privileges at Erlanger, Parkridge, CHI Memorial, Tennova and Rhea County hospital systems.