Role Description Provides direct oversight of coding, CPT capture, and audit reconciliation processes to ensure accurate and compliant billing, proper device cost reporting, and protection of reimbursement across cardiovascular and interventional service lines. Partners with Revenue Integrity, Supply Chain, CDI, Finance, and Clinical Operations to lead process improvements, educate staff, and ensure compliance with regulatory and payor requirements. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment. Monitors department efficiencies and assumes responsibility for meeting departmental goals. - Conducts routine retrospective and prospective facility and technical coding reviews, specialized and focused reviews on cardiology/interventional radiology, and other reviews as directed by coding leadership and compliance. - Impacts processes to include CPT capture concurrently to validate medical necessity, device capture, documentation and coding, data entry, billing, provide expert analysis and reporting of CPT capture performance. - Acts as a department liaison for charge capture of supplies and devices and identification and tracking of issues related to reimbursement in partnership with other revenue integrity domains to maximize revenue and increase efficiency. - Utilizes in-depth understanding of cardiac/interventional radiology issues, processes, reporting instruments, and other tools and techniques involved with measuring and analyzing the revenue cycle. Qualifications - High School Education/GED or equivalent: Required - Bachelor's Degree or equivalent combination of education/related experience: Preferred - Five years' relevant experience in cardiovascular/interventional hospital coding, revenue integrity, CPT and device capture with demonstrated expertise in cardiovascular/interventional cases: Required - Experience in audit oversight, staff mentoring, and process improvement: Preferred - Certified Coding Specialist (CCS): Required - Certified Interventional Radiology Cardiovascular Coder (CIRCC): Required Requirements - Directs daily operations of staff and performs supervisory functions. - Ensures accurate, compliant, and timely assignment of workload and work backlogs. - Monitors and assesses performance of coding staff to assure timely, accurate coding of inpatient discharges, ambulatory surgery encounters, emergency department, clinic encounters, and diagnostic services. - Assists with resolving coding/billing issues. - Reviews medical records in order to code and abstract medical information to be submitted to financial reimbursement as required for the UB-04/1500 form and using IPPS and OPPS methodologies (Acute). - Ensures compliance with rules and regulations approved by CMS using coding conventions approved by coding guidelines (Pro-fee). - Maintains department statistics on work volume, productivity and accuracy for use in long-range planning and budgeting. - Conducts performance reviews and provides input on direct reports for human resource decisions such as hiring, promotions and disciplinary actions. - Participates in the development of employees. - Delegates the work appropriately, provides clear expectations and follows up to ensure progress and overcome roadblocks. - Identifies associates and team priorities based on business direction and adjusts when needed. - Leads by example and shares knowledge and experiences with associates and team. - Models a respectful work environment, creates accountability and recognizes accomplishments. - Provides timely feedback to encourage success and connects opportunities for associates' development. - Identifies top talent to achieve the desired results. - Promotes and builds a diverse yet cohesive team to accomplish objectives and aligns associates' skills to fill gaps. - Lead review of audit findings for cardiovascular/IVR cases, ensuring proper capture of high-cost devices and supplies (e.g., TAVR, MitraClip, Impella, Watchman, Barostim). - Identify reimbursement opportunities, DRG shifts, and missed CPT/HCPC codes, quantifying financial impact and escalating systemic issues. - Ensure reconciliation of device types within 48 hours to maintain compliance with CMS cost reporting and device offset rules. - Oversee coding and CPT workflows to minimize missed, duplicate, or inaccurate charges. - Collaborate with Cardiac/IVR, Revenue Integrity and PFS to prevent denials and reduce revenue leakage. - Monitor compliance with NTAP requirements, modifiers, and audit documentation standards. - Partner with Supply Chain, Category Management, Finance and Department teams to align on device pricing, cost thresholds, and reimbursement strategies. - Provide support to department IT/Epic build teams for CPT/HCPC mapping and workflow optimization. - Develop and deliver coder/provider education on audit findings, documentation gaps, and best practices. - Create and maintain job aids, cheat-sheets, and workflow tools to support team efficiency and accuracy. - Mentor staff, fostering growth and knowledge-sharing across Revenue Integrity and coding teams. - Drive initiatives to streamline workflows, reduce denial rates, and enhance CPT/HCPC capture. - Lead root cause analyses and corrective action plans for recurring revenue cycle issues. - Contribute to contracts, business cases, and presentations demonstrating financial and compliance benefits of improved oversight. - Performs other job-related duties as assigned. Benefits - Adventist Health is committed to the safety and wellbeing of our associates and patients. - All associates are required to receive all required vaccinations as a condition of employment and annually thereafter, where applicable. - Medical and religious exemptions may apply.

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