Certified Outpatient Coder – Cardiac Surgery
About the Role
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.
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.
Requirements
- 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.
Skills
- 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.
- 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.
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.
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.
Schedule
Workday Day (United States of America)
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including:
- Medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance
- Short- and long-term disability
- Flexible spending accounts
- Retirement plans
- Tuition assistance
- Voluntary benefits, which provide colleagues with access to group rates on insurance and discounts
Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.