Senior OP IVR and Cardiology Coder

Under the supervision of the Outpatient Coding Manager and OP Coding Supervisor, the Senior Coding Specialist is responsible for the accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPCS Level II, modifiers, revenue codes, and APC classifications for complex hospital outpatient encounters. The role reviews outpatient records and clinical documentation to ensure appropriate code assignment, regulatory compliance, and reimbursement integrity across clinic, interventional radiology, cardiology, infusion, observation, procedural, and ancillary departments. The Senior Coding Specialist serves as a subject matter expert, works with Coding Leadership, OP Coding Validators, Revenue Integrity, Compliance, and Clinical Operations teams, and provides mentoring, education, quality review support, and guidance for complex coding scenarios.

Responsibilities

Review and assign ICD-10-CM, CPT, HCPCS Level II, modifiers, revenue codes, and APC classifications for complex outpatient hospital encounters; Accurately code facility services within interventional radiology and cardiology; Interpret coding guidelines, payer policies, CMS regulations, and official coding conventions; Apply NCCI, MUEs, OPPS regulations, and payer-specific requirements; Evaluate documentation to ensure services are appropriately supported and billed; Assist with coding quality reviews and audits of outpatient facility coding staff; Serve as a coding resource and mentor for coding team members; Provide education regarding coding updates, regulatory changes, and department policies; Assist with onboarding and training of new coders; Support continuing education initiatives within the coding department; Function as a lead resource for escalated and complex coding scenarios; Provide recommendations regarding workflow improvements and coding best practices; Participate in departmental projects, system implementations, and process improvement initiatives

Requirements

Associate degree in Health Information Management or completion of an AHIMA or AAPC Coding Certification program (preferred); High School Diploma or equivalent (required); RHIA, RHIT, or CCS from AHIMA, or CPC or COC from AAPC (required); CIRCC from AAPC (required); Minimum 5 years of ICD-10-CM and CPT/HCPCS outpatient facility coding assignment (required); Minimum 2-4 years of interventional and cardiovascular facility coding (preferred); Prior experience performing coding audits, quality reviews, or mentoring (preferred); Experience in large health systems or academic medical centers (preferred); Working knowledge of interventional radiology and cardiovascular procedures including cardiac catheterizations, vascular surgeries, injections and infusions; Medical terminology; Proficiency in Microsoft Office Excel, Word, and PowerPoint; Knowledge of current ICD-10-CM and CPT Official Guidelines for Coding and Reporting; Knowledge of medical records content and management; Working knowledge of the EMR, including structured data and database management; Strong written communication skills; Ability to educate, mentor, and support coding staff; Knowledge of laws and regulations about health information and patient confidentiality; Adherence to Department, Hospital, and Human Resource Policies; Secured remote location compliant with HIPAA guidelines; Internet access to support BILH system requirements; Ability to sit for extended periods of time

Nice to have

Epic experience; 3M-360 Computer Assisted Coding; Previous lead coder or senior coder experience; Expert level ICD-10-CM and CPT Interventional Radiology and Cardiology code assignment skills based on BILH IR Coder Exam