Facility: Kennestone Hospital

Job Summary:

Provides clinical documentation improvement, auditing, coding and charge entry for all Interventional Radiology, Vascular Intervention, Neuro Intervention, Vascular Surgery (Surgical Cases) and TAVR procedures performed in the Vascular Institute. This includes chart and report review and supply / implant inventory utilized. Reviews clinical documentation in the procedural event log and provides coding and compliance training to physicians, clinical personnel, billing and/or hospital staff. Conducts medical record reviews to ensure the accurate and appropriate documentation, coding, charging and billing practices to ensure compliance and to meet coding regulatory standards. Reviews documentation to ensure that the appropriate diagnostic and procedural ICD-10, CPT-4 and HCPCS codes can be assigned to the greatest specificity for appropriate reimbursement. Reviews and verifies that the coding, demographic, encounter and charge related information is entered correctly into the patient record. Works in conjunction with Epic Radiant team, Compliance, Revenue Management Department (RMD) and HIM departments for correct coding and billing of Clinical Trials and new procedures being evaluated and performed in the Vascular Institute. Researches new procedures gathering information on CPT and DRG reimbursement, the cost of supplies required for the procedure and in-service opportunities for staff and physicians. Works with RMD to build charge codes for these new procedures and serves as Clinical and Coding Liaison. Works closely with the Lawson system and collaborates with supply chain to ensure all new supplies are assigned proper SUP codes and item numbers. Troubleshoots issues that prevent charges from posting. Processes "Bill-Only" requisitions for supply items when needed. Reconciles Spacetrax daily. Creates charge sheets to be used by all Hospitals for commonly performed procedures in the department and maintains them for any and all coding changes. Provides training to for a back-up coding person for the Cath Lab and EP Lab when needed. Provides data to Management for financial analysis.

Core Responsibilities and Essential Functions:

Performs charge reconciliation functions daily to ensure appropriate billing of supplies and procedures. Resolves issues with supplies not crossing to charge capture. Works closely with Revenue Management and collaborates with the supply chain to ensure all new supplies are assigned proper SUP Codes and item numbers. Processes Bill-Only requisitions for Interventional Devices as needed. Clears the high dollar / high quantity work queues daily to prevent billing errors and troubleshoot problems in a timely manner. Audits Implant record for devices, troubleshoots the record for errors and resolves issues so that revenue can post. Reviews and verifies all interventional and surgical procedures performed in the Vascular Institute for accuracy of procedural coding and documentation to support the coding compliance and ICD-10 and/or CPT-4 coding regulatory standards. Uses knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. Performs in-services and creates training aids to promote coding knowledge among the staff. Educates physicians and clinical staff on any and all coding changes quarterly to ensure complete and accurate documentation to support appropriate diagnostic and procedural ICD-10 and CPT-4 codes to the greatest specificity for the most accurate reimbursement for all vascular procedures performed in the Vascular Institute. Monitors and reviews Revenue Usage Reports daily to ensure revenue is posting. Verifies surgical statistics on a monthly basis. Works closely with the Epic Radiant team to build new procedures and templates for the staff to follow and updates supply preference lists. Reconciles Spacetrax report daily. Creates charge sheets to be used by all WellStar Hospitals for commonly performed procedures in the department and maintains them for any and all coding changes. Works with RMD to build or bundle charge codes for any new procedures. Downloads data from Spacetrax and Epic as needed for management financial analysis. Performs other duties as assigned Complies with all WellStar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

Some high school Completed Course in anatomy and physiology at College level. Required

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• Cert Prof Coder or Cert Prof Coder - Hospital OP

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 2 years of acute care coding or billing or charge capture experience. Required and Computer/Data Entry experience. Required

Required Minimum Skills:

Ability to communicate with various members of the healthcare team. Ability to use EXCEL, WORD and have basic computer operational knowledge