Certified Outpatient Coder – Cardiac Surgery

Job Details

Certified Outpatient Coder – Cardiac Surgery

Job Description

Position Summary

We are seeking an experienced Certified Outpatient Coder specializing in cardiac surgery to support accurate coding, billing, compliance, and revenue cycle integrity for a high-volume cardiovascular surgical program. This role is responsible for reviewing outpatient medical records and assigning appropriate ICD-10-CM, CPT, HCPCS, and modifier codes related to cardiac surgery procedures, diagnostic testing, and associated clinical services.

The ideal candidate has advanced knowledge of cardiovascular anatomy, cardiac surgical procedures, outpatient facility and/or professional fee coding guidelines, and payer-specific requirements. This position works collaboratively with physicians, APPs, clinical staff, billing teams, and revenue cycle leadership to ensure coding accuracy, optimize reimbursement, and maintain regulatory compliance.

Essential Responsibilities

• Review and accurately code outpatient cardiac surgery encounters, procedures, diagnostic studies, and related services using ICD-10-CM, CPT, and HCPCS coding systems.
• Assign appropriate modifiers and ensure compliance with NCCI edits, Medicare guidelines, and payer-specific rules.
• Interpret operative reports, physician documentation, catheterization reports, imaging studies, and procedural documentation related to cardiovascular surgery.
• Abstract coding and clinical data into the electronic medical record and billing systems.
• Identify documentation deficiencies and communicate with providers regarding clarification or education opportunities.
• Maintain productivity and quality standards established by department leadership.
• Support denial management and appeals by reviewing coding-related denials and providing corrective recommendations.
• Participate in internal coding audits, compliance initiatives, and process improvement efforts.
• Remain current on coding updates, payer regulations, and cardiovascular coding changes.
• Collaborate with cardiac surgery leadership, revenue cycle teams, and compliance departments to improve coding accuracy and charge capture.

Required Qualifications

• High school diploma or equivalent required; Associate’s degree preferred.
• Current coding certification required, including one of the following:
  • AAPC Certified Professional Coder (CPC)
  • AHIMA Certified Coding Specialist (CCS)
  • Certified Outpatient Coder (COC) preferred.
• Minimum of 3 years of outpatient coding experience required.
• Minimum of 2 years of cardiovascular or cardiac surgery coding experience strongly preferred.
• Strong knowledge of:
  • ICD-10-CM
  • CPT and HCPCS coding
  • Cardiac surgery terminology and anatomy
  • Medicare and commercial payer regulations
  • Outpatient facility and/or professional fee coding guidelines
• Experience with Epic and encoder software preferred.
• Excellent analytical, organizational, and communication skills.
• Ability to work independently while maintaining high accuracy and productivity standards.

Preferred Experience

• Coding experience in:
  • CABG procedures
  • Valve repair/replacement
  • TAVR/TMVR
  • ECMO
  • Thoracic aortic procedures
  • Minimally invasive cardiac surgery
  • Cardiac outpatient testing and follow-up procedures
• Experience supporting academic medical centers or large cardiovascular programs preferred.

Knowledge, Skills, and Abilities

• Advanced understanding of cardiovascular procedural documentation.
• Strong attention to detail and critical thinking skills.
• Ability to prioritize workload in a fast-paced healthcare environment.
• Strong interpersonal skills and ability to collaborate across multidisciplinary teams.
• Commitment to confidentiality, compliance, and coding integrity.

Working Conditions

• Hybrid or remote work eligibility based on organizational policy and performance standards.
• Prolonged computer use and sedentary work environment.
• May require occasional attendance at departmental meetings or educational sessions.

Sample Performance Metrics

• Coding accuracy rate ≥ 95%
• Timely completion of assigned work queues
• Denial reduction and resolution support
• Compliance with departmental productivity standards

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Jefferson University Ph