Senior Vascular Surgery Professional Coder (CPC, CCS-P, CIRCC)

Core 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

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
• 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

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