Surgery Charge Entry

Full-time Description

Job Summary

Under the direction of the Billing Office Lead and Chief Operating Officer, Ensures all surgery charges are received, entered and billed in a consistent and timely manner.

This is a full-time position, Monday through Friday. This position is eligible for medical, dental, and vision insurance, employer-paid long-term disability insurance, continuing education funds, and PTO.

THE DETAILS OF THE JOB

Essential Duties And Responsibilities

Surgical Coding & Documentation Review

• Review operative reports, clinic notes, imaging, and diagnostic results to determine accurate CPT, ICD-10-CM, and HCPCS codes.
• Ensure all orthopedic surgery CPT codes are supported by proper medical documentation.
• Retrieve and review all surgery charge sheets daily.
• Compare clinical records to charge sheets to ensure accuracy and completeness.
• Audit and correct surgeries that were pre-coded by the provider based on CCI edits, LCD/NCD guidelines, payer rules, and internal policy.
• Communicate coding corrections or education needs to the Office Manager and providers.
• Ensure all reported CPT codes are linked to appropriate ICD-10 diagnosis codes.
• Assign correct use of modifiers, laterality, add-on codes, and assist/co-surgeon indicators.
• Check hospital and ASC databases for missing surgery documentation or operative notes to ensure all procedures performed by providers are billed.
  
  

Charge Entry & Claim Submission

• Enter charges for all surgeries within 5 days of receipt.
• Review surgery charge sheets for correct provider information (surgeon, co-surgeon, assistant).
• Process and code all hospital-based trauma surgeries; work with the insurance verification team to ensure charts are created and completed for billing.
• Report all missing surgery charges weekly to the Billing Office Manager.
• Submit all claims to the clearinghouse nightly.
• Work all clearinghouse rejections, insurance rejections, and ERA payer denials daily.
• Correct coding or documentation issues and resubmit claims per payer guidelines.
• Submit medical records and initiate first-level appeals when needed.
  
  

Compliance & Quality Assurance

• Ensure coding complies with AMA guidelines, CMS/Medicare rules, NCCI edits, LCDs/NCDs, and all payer-specific policies.
• Follow all guidelines from contracted insurance companies.
• Maintain high accuracy across internal audits and quality checks.
• Report monthly billing or coding trends to the Billing Office Manager (e.g., incorrect modifier use, CPT selection errors, diagnosis issues).
• Maintain confidentiality of patient information in accordance with HIPAA, OSHA, and organizational policies.
  
  

Revenue Cycle Collaboration

• Work closely with billers to review surgical accounts regularly and ensure claims are processed/paid correctly by insurers.
• Assist with documentation improvement by providing feedback to clinical staff and providers.
• Support resolution of patient account inquiries, offering courteous and professional assistance.
  
  

General Office & Team Duties

• Answer telephone calls as needed and provide support to patients, providers, and internal departments.
• Maintain a clean and organized work area.
• Participate as a collaborative team member within the billing department.
• Attend required meetings and training sessions.
• Perform related duties as assigned.
  
  

Requirements

Performance Requirements:

Knowledge, Skills, & Abilities

• Ability to communicate clearly.
• Ability to speak clearly and concisely.
• Ability to read, understand and follow oral and written instruction.
• Ability to keep detailed reports.
• Ability to utilize medical software for billing of all surgery claims
• Ability to sort and file materials correctly by alphabetic or numeric systems.
• Ability to view data on clinic information systems, e.g. scheduling software, transcription software, company e-mail.
• Ability to operate modern business office machinery, e.g. facsimile machine, copy machine, postage meter, document shredder, scanner, computer.
• Ability to work under stress, with interruptions and deadlines.
• Ability to establish and maintain effective working relationships with patients, physicians, employees and the public.
• Ability to converse in a calm and friendly manner.
• Skill in answering the telephone in a pleasant and helpful manner.
• Knowledge of Medical Office procedures.
• Knowledge of Billing Office procedures.
• Knowledge of Medicare LCD’s and NCD’s; or be able to locate
• Knowledge of NCCI common edits and guidelines
• Knowledge of CPT, ICD-10 and HCPCS coding manuals and proper usage.
• Knowledge of grammar, spelling and punctuation.
• Knowledge of basic arithmetic to make simple calculations.
• Knowledge of VSO policies and procedures.
  
  

Qualifications

Education & Certifications

• High school diploma or equivalent required.
• Certification strongly preferred: CPC, COC, CCS-P, or other AAPC/AHIMA credentials.
• Advanced knowledge of orthopedic coding is highly desired.
  
  

Experience

• Minimum of 2 years of surgical coding, preferably in orthopedics.
• Experience reading and interpreting complex operative reports.
• Familiarity with EMR/EHR systems (such as eCW, Epic, Athena, or similar).
• Strong understanding of CCI edits, payer guidelines, and Medicare rules.
  
  

Skills & Competencies

• Strong orthopedic anatomy and terminology knowledge.
• Exceptional attention to detail and accuracy.
• Ability to work independently and meet productivity/accuracy standards.
• Strong communication skills for provider education and cross-department collaboration.
• Ability to analyze denials and solve coding-related issues quickly.
  
  

Work Environment & Schedule

• Office Setting
• Full-time position with daily and weekly productivity benchmarks.
  
  

Supervisory Responsibilities

This job has no supervisory responsibilities.

Typical Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. .

Work may require sitting for long periods of time, also stooping, bending and stretching for supplies with occasional lifting of files or paper weighing up to 50 pounds.

Requires manual dexterity sufficient to operate a keyboard and mouse, operate a calculator, telephone, copier, scanner and other office equipment as necessary.

Vision must be correctable to the normal range and hearing must be in the normal range for telephone contact. Specific verbal abilities required by this job include audible and coherent speech. To view a computer, monitor for long periods of time. The ability to distinguish words and letters in their proper order is also required.

As a representative of Vail-Summit Orthopaedics, the individual is expected to maintain a neat and professional appearance, demonstrate a commitment to always serve the needs of the patients and physicians, and uphold the guidelines as set forth in the employee manual.

Typical Working Conditions

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Work is primarily performed in an office/cubicle setting. Involves frequent contact with patients via telephone. Work may be stressful at times. Interaction with others is constant and interruptive.

NOTICE

This job description is not intended to be a comprehensive list of activities, duties or responsibilities for this job. The duties, expectations and actions listed for this role may change at any time with or without notice.

EEO STATEMENT

We believe diversity makes us stronger. Vail-Summit Orthopaedics & Neurosurgery provides equal employment opportunities to all employees and applicants without regard to sex, gender identity, sexual orientation, genetics, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

Salary Description $22.00 - $31.00