Electrophysiology Coder (CPC)

Cardiology Consultants of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 60,000 - 110,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Cardiology Consultants of Philadelphia (CCP) is hiring a full-time Electrophysiology Coder (CPC) to join our Philadelphia, PA office. The CPC codes EP studies, ablations, device implants, and related visits, ensuring compliance with CMS and payer requirements while supporting denials resolution and education for clinicians.

The role requires CPC certification, 3+ years in cardiology coding, and EP-specific experience.

Qualifications

• Active CPC certification through AAPC, or equivalent credential in active status
• Minimum of three years of professional medical coding experience in cardiology
• Electrophysiology coding experience strongly preferred
• Working knowledge of ICD-10-CM, CPT, HCPCS, and E/M guidelines

Responsibilities

• Review provider documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes for EP procedures and device services
• Code EP diagnostic studies, ablations, device implants, programming, and clinic visits
• Apply coding guidelines, modifiers, NCCI, and global surgical package rules accurately
• Review claims and edits before submission and resolve coding errors
• Reconcile EP procedures against charges to ensure all services are captured
• Manage assigned coding queues to productivity and accuracy standards
• Query providers using compliant, non-leading queries and escalate issues
• Provide feedback to physicians and document trends for education
• Support denials/appeals with the billing team and identify root causes
• Research payer-specific coding requirements and device coverage policies
• Maintain knowledge of CMS regulations and annual CPT/HCPCS/ICD-10-CM updates
• Maintain accurate coding records within GPMS and support athenaOne transition
• Ensure HIPAA compliance and confidentiality of PHI
• Provide coding coverage for general cardiology and ancillary services as needed
• Assist with workflow testing during athenaOne rollout
• Maintain documentation and policy adherence across coding workflows

Skills

Attention to detail

Communication skills

Independent work

Education

AS/BS in Health Information Management or related field

Tools

GPMS

athenaOne

Job description

Cardiology Consultants of Philadelphia (CCP) is a professional medical organization committed to the healing mission of Medicine and is part of a national cardiology platform, Cardiovascular Logistics (CVL). Together, we share the same mission to provide our patients with the highest quality cardiovascular care available. Join our team and be a part of an organization that is dedicated to improving patient outcomes and shaping the future of heart health.

CCP specializes in providing comprehensive cardiology care and currently has over 30 locations throughout the Philadelphia region. We are currently hiring for full-time Electrophysiology Coder (CPC) to work at our Philadelphia, PA Office.

Summary

The Certified Professional Coder - Electrophysiology is responsible for accurate, compliant, and timely coding of the electrophysiology (EP) service line for Cardiology Consultants of Philadelphia (CCP). This is a full-time position dedicated to EP coding, with coverage of general cardiology and ancillary services as needed. The CPC reviews provider documentation and assigns ICD-10-CM, CPT, and HCPCS codes across EP studies and catheter ablations, cardiac implantable electronic device procedures, device programming and monitoring, cardioversion, and EP clinic evaluation and management services, ensuring that every service billed is supported by the clinical record and meets payer and regulatory requirements. This role works assigned coding queues to defined productivity and accuracy standards, reviews claims and coding edits prior to submission, and resolves coding-related denials and rejections in partnership with the billing and insurance follow-up team. The CPC queries providers through the established query process, participates in prospective and retrospective coding audits, and contributes to the documented provider feedback and education loop. The position requires current, working knowledge of CMS regulations, Medicare and commercial payer policy, and annual CPT, HCPCS, and ICD-10-CM updates, and performs coding within the GPMS practice management system with support for the planned transition to athenaOne. The CPC reports to the Director of Coding & Payments and is expected to work independently within documented coding policies, procedures, and workflows.

Please note that this role is entitled to a $500.00 sign-on bonus.*

Key Responsibilities

• Review provider documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes for electrophysiology procedures, device services, and EP clinic evaluation and management visits in accordance with official coding guidelines and payer requirements
• Code the full range of electrophysiology services, including diagnostic EP studies; catheter ablation for supraventricular tachycardia, atrial fibrillation and flutter, and ventricular tachycardia; pacemaker, ICD, and CRT implants, generator changes, lead revisions, and lead extractions; conduction system and His-bundle pacing; implantable loop recorder insertion and removal; left atrial appendage occlusion; device programming, interrogation, and remote monitoring; cardioversion; and tilt table testing
• Apply evaluation and management guidelines, modifiers, global surgical package rules, NCCI and device-related bundling edits, and medical necessity requirements (LCD/NCD) accurately and consistently, including the national coverage determinations governing ICD and ablation services
• Review claims and coding edits prior to submission, identifying and resolving coding errors, missing or unbilled charges, and documentation deficiencies before the claim is released
• Reconcile EP procedure and device schedules against coded and billed charges to ensure no procedure or device service goes uncaptured
• Work assigned coding queues to established productivity and accuracy standards, keeping uncoded and DNFB (discharged not final billed) aging within defined limits and escalating backlogs before they affect the close
• Query providers through the established query process in a compliant, non-leading manner, and elevate recurring documentation patterns to the Director of Coding & Payments
• Contribute to the provider feedback and education loop by documenting coding findings and trends in the format and cadence established by the Director of Coding & Payments, so that feedback to physicians is consistent, retrievable, and auditable
• Support resolution of coding-related denials, rejections, and appeals in partnership with the billing and insurance follow-up team, and identify root causes so that recurring issues are prevented rather than reworked
• Research and apply payer-specific coding, billing, prior authorization, and device coverage requirements, including any gold-card or authorization-waiver status applicable to CCP services
• Maintain current knowledge of CMS regulations, Medicare and commercial payer clinical policies, and annual CPT, HCPCS, and ICD-10-CM updates, with particular attention to the annual changes affecting electrophysiology and device coding, and communicate changes that affect CCP coding and billing workflows
• Maintain accurate and retrievable coding records and work within documented coding policies, procedures, and workflows, contributing to keeping that documentation current as guidelines and payer requirements change
• Provide coding coverage for general cardiology, diagnostic testing, and ancillary services as needed to support department workload and coverage during absences
• Perform coding and charge review within the GPMS practice management system and support the planned transition to athenaOne, including workflow testing and validation as requested
• Ensure compliance with CMS coding and billing guidance, OIG guidance, payer requirements, HIPAA, and internal revenue cycle and compliance policies, and maintain strict confidentiality of protected health information

Qualifications

• High school diploma or equivalent required; associate's or bachelor's degree in Health Information Management, health sciences, or a related field preferred. An equivalent combination of experience and active professional certification will be considered in lieu of a degree
• Active Certified Professional Coder (CPC) certification through AAPC, or an equivalent recognized coding credential (CCS through AHIMA or comparable), required and maintained in active status
• Specialty or advanced credential preferred — Certified Cardiology Coder (CCC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), or Certified Risk Adjustment Coder (CRC)
• Minimum of three years of professional medical coding experience in cardiology or a cardiovascular subspecialty required
• Electrophysiology coding experience strongly preferred, including ablation, device implant and revision, and device monitoring services; candidates with strong cardiology procedural coding experience and demonstrated ability to develop electrophysiology proficiency will be considered
• Demonstrated working knowledge of ICD-10-CM, CPT, and HCPCS coding, evaluation and management guidelines, modifier application, NCCI edits, and global surgical package rules
• Working knowledge of Medicare and commercial payer requirements, including medical necessity, LCD and NCD application, device coverage criteria, and prior authorization requirements
• Experience reviewing clinical documentation — including procedure reports, device reports, and operative notes — for coding accuracy, and writing compliant, non-leading provider queries
• Experience working coding-related claim denials, rejections, appeals, and coding audits
• Experience with an electronic health record and practice management or billing system required; GPMS experience preferred, and athenaOne a plus, with the ability and willingness to develop athenaOne proficiency
• Ability to work independently, manage competing priorities, and consistently meet productivity and accuracy expectations without close supervision
• Strong attention to detail, strong written and verbal communication skills, and the ability to interact professionally and constructively with physicians, practice staff, and revenue cycle colleagues

Benefits

Cardiology Consultants of Philadelphia provides medical, vision, dental, 401k, profit sharing, LTD, generous PTO, and paid holiday time.