SENTA Partners is seeking a Professional Coder to support ENT and Allergy private practices by reviewing clinical documentation and assigning accurate CPT, HCPCS, ICD-10-CM, and modifier codes. This role supports compliance, clean claims, accurate reimbursement, and revenue integrity in a primarily remote environment.
The coder will work closely with providers, clinical staff, revenue cycle teams, and coding leadership to identify coding opportunities, resolve discrepancies, reduce denials, and ensure adherence to coding and billing guidelines.
Requirements & Qualifications
Core responsibilities
- Review physician and advanced practice provider documentation to determine appropriate diagnosis and procedure codes.
- Assign accurate CPT, HCPCS, ICD-10-CM, and modifier codes based on documentation and coding guidelines.
- Apply E/M coding principles, including medical decision-making and time when applicable.
- Review surgical, procedural, office, diagnostic, allergy, and ENT documentation for coding accuracy.
- Identify separately identifiable services, bundled services, add-on codes, bilateral procedures, multiple procedures, and modifier needs.
- Review claims for NCCI edits, MUEs, medically necessary units, payer-specific billing rules, and related issues.
- Research payer policies, MAC requirements, LCDs, NCDs, and reimbursement policies.
- Identify documentation deficiencies and communicate with providers for clarification.
- Prepare compliant coding queries when documentation is insufficient.
- Assist with denials, appeals, coding corrections, and payer inquiries.
- Monitor changes to CPT, HCPCS, ICD-10-CM, CMS, and commercial payer requirements.
- Participate in audits and quality assurance activities.
- Maintain productivity and accuracy standards.
- Escalate complex coding issues to leadership or compliance resources.
Qualifications
- High school diploma or equivalent required.
- Professional coding certification such as CPC or CCS.
- Minimum 2 years of professional medical coding experience.
- Working knowledge of CPT, HCPCS, ICD-10-CM, NCCI edits, MUEs, and Medicare coding requirements.
- Knowledge of professional fee coding and physician practice billing.
- Strong understanding of medical terminology, anatomy, and clinical documentation.
- Ability to interpret complex medical records and determine correct code assignment.
- Strong analytical skills and attention to detail.
- Ability to research and interpret payer and regulatory requirements.
- Excellent written and verbal communication skills.
- Ability to work independently and meet productivity and quality standards.
- Experience coding ENT clinic/surgery and allergy specialties preferred.
Benefits & Perks
Benefits
- Medical, dental, and vision coverage
- Health Savings Account (HSA)
- Flexible Spending Account (FSA)
- Short- and long-term disability
- Holidays and paid time off (PTO)
- Employee Assistance Program (EAP)
- Retirement contribution program with 401(k) match
Additional perks
- Flexible scheduling
- Paid holidays
- Wellness incentives
- Continuing education opportunities
- Networking opportunities
- Access to the latest technology
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
4 weeks ago
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