Single Pathway Cardiology Cath Lab/ IVR Coder in East Haven, Connecticut at GeBBS Healthcare Solutions, Inc.

The Single Pathway Cardiology Cath Lab/Interventional Radiology (IVR) Coder is responsible for accurately assigning professional and facility codes for diagnostic and interventional cardiology and radiology procedures from a single medical record review. This role ensures complete and compliant code assignment, appropriate charge capture, and adherence to all federal, state, payer, and organizational coding guidelines. The coder serves as a subject matter expert for complex procedural coding.

Roles & Responsibilities

• Review medical records and supporting documentation for outpatient and inpatient Cath Lab and IVR encounters.
• Assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, modifiers, and applicable revenue codes for both facility and professional billing pathways.
• Abstract and validate procedural details, including diagnostic cardiac catheterizations, percutaneous coronary interventions (PCI), electrophysiology procedures, peripheral vascular interventions, endovascular procedures, interventional radiology procedures, device placements and removals, embolization and thrombolytic procedures
• Ensure accurate assignment of modifiers, including but not limited to Modifier 26, Modifier TC, Modifier 59, Modifier XEPSU, Modifier 51, Modifier 76/77
• Identify documentation deficiencies and escalate opportunities for provider clarification.
• Review and reconcile charges to ensure complete charge capture and compliance with coding guidelines.
• Maintain productivity and quality standards established by the organization.
• Research and apply coding updates, payer policy changes, and regulatory guidance impacting Cath Lab and IVR services.

Technical Skills

• Advanced knowledge of:
  • ICD-10-CM diagnosis coding
  • CPT and HCPCS coding systems
  • Modifier assignment and National Correct Coding Initiative (NCCI) edits
  • Medicare Outpatient Prospective Payment System (OPPS)
  • Ambulatory Payment Classifications (APCs)
  • Physician Fee Schedule (PFS)
  • Revenue codes and charge reconciliation processes
• Expertise in:
  • Cardiac catheterization coding
  • Coronary interventions and device procedures
  • Electrophysiology coding
  • Peripheral vascular intervention coding
  • Interventional radiology and endovascular coding
  • Imaging guidance coding and bundling rules
• Proficiency in Athena
• Strong analytical, problem-solving, and communication skills.
• Ability to work independently in a remote, production-driven environment.

• Minimum of three (3) years of recent coding experience in:
  • Cardiac Catheterization Laboratory coding
  • Interventional Radiology coding
  • Peripheral Vascular and Endovascular procedure coding
• Experience coding both facility and professional services in a single-pathway workflow required.
• Demonstrated experience with complex cardiovascular and interventional procedural coding.

Required Certifications

One or more of the following certifications required:

• American Health Information Management Association Certified Coding Specialist (CCS)
• American Academy of Professional Coders Certified Professional Coder (CPC)
• Certified Interventional Radiology and Cardiovascular Coder (CIRCC) – strongly preferred
• Certified Evaluation and Management Coder (CEMC) – preferred for professional E/M coding support

Performance Expectations

• Coding Accuracy: =95%
• Productivity: Meets departmental encounter-per-hour standards based on case complexity
• Timely Completion of Work Queues