ENT/Allergy Medical Coder – Precision & Compliance

Sentapartners

Atlanta (GA)

Hybrid

USD 65,000 - 90,000

Full time

5 days ago
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Benefits offered by this job

Health benefits
HSA
FSA
Disability insurance
Paid time off

Job summary

SENTA Partners is a leading MSO supporting ENT and Allergy private practices. We seek a Professional Coder to assign CPT, HCPCS and ICD-10-CM codes for professional services, ensuring compliant submissions and accurate reimbursement. You will collaborate with providers and revenue cycle teams, resolve denials, and stay current with CMS and payer policies.

Prior ENT coding experience is preferred. We offer comprehensive health benefits, HSA, FSA and disability coverage, with a focus on a

Qualifications

  • Professional-fee coding knowledge required in ENT preferred.
  • Strong knowledge of CPT, HCPCS and ICD-10-CM coding practices.
  • Familiarity with payer requirements, reimbursement methodologies and CMS rules.
  • Ability to identify documentation gaps and query providers for clarification.

Responsibilities

  • Review physician and APP documentation to determine diagnosis and procedure codes.
  • Assign CPT, HCPCS, ICD-10-CM and modifiers in compliance with guidelines.
  • Apply E/M coding principles when applicable and document rationale.
  • Identify bundled services, add-on codes and modifier requirements.
  • Review claims for NCCI edits, MUEs and payer-specific rules.
  • Research payer policies and LCDs/NCDs affecting coding and reimbursement.
  • Communicate coding clarifications to providers and documentation teams.
  • Assist with denials, appeals and payer inquiries as needed.
  • Stay updated on CPT/HCPCS/ICD updates and coding guidance.

Job description

SENTA Partners is a leading Management Services Organization (MSO) specializing in providing comprehensive support to ENT and Allergy private practices. Our mission is tohelp people Breathe better, Hear better, Livebetter. At SENTA, we focus on the operational efficiencies and financial performance of our partner practices, allowing physicians to focus on delivering exceptional patient care. We are committed to fostering a collaborative and supportive work environment where our employees can thrive and grow.

Position Summary

The Professional Coder is responsible for reviewing clinical documentation and accurately assigning CPT, HCPCS, ICD-10-CM, and applicable modifier codes for professional medical services. This role ensures compliance with established coding guidelines, CMS regulations, NCCI edits, payer policies, and organizational standards to support accurate reimbursement, clean claims, and regulatory compliance. The Professional Coder collaborates closely with providers, clinical staff, revenue cycle teams, and coding leadership to identify documentation and coding opportunities, resolve discrepancies, reduce denials, and promote revenue integrity. The ideal candidate possesses strong knowledge of professional-fee coding, medical terminology, payer requirements, and reimbursement methodologies, with experience in ENT and surgical coding preferred.

Key responsibilities

  • Review physician and advanced practice provider documentation to determine the appropriate diagnosis and procedure codes.
  • Assign accurate CPT, HCPCS, ICD-10-CM, and modifier codes based on documentation and applicable billing and coding guidelines.
  • Apply appropriate evaluation and management (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 and appropriately report separately identifiable services, bundled services, add-on codes, bilateral procedures, multiple procedures, and modifier requirements.
  • Review claims for NCCI edits, Medically Unlikely Edits (MUEs), medically necessary units, payer-specific billing rules, and other claim-editing issues.
  • Research payer policies, Medicare Administrative Contractor (MAC) requirements, Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and other applicable reimbursement policies.
  • Identify documentation deficiencies and communicate professionally with providers regarding coding clarification and documentation requirements.
  • Prepare and submit compliant coding queries when documentation does not support accurate code assignment.
  • Assist with claim denials, appeals, billing or coding corrections, and payer inquiries.
  • Monitor changes to CPT, HCPCS, ICD-10-CM, CMS, and commercial payer coding and reimbursement requirements.
  • Maintain current knowledge of specialty-specific coding guidelines and payer policies.
  • Participate in coding audits and quality assurance activities.
  • Identify trends in denials, underpayments, overpayments, billing and coding errors, and communicate findings to coding and revenue cycle leadership.
  • Maintain required coding productivity and accuracy standards.
  • Protect patient confidentiality and comply with HIPAA and organizational privacy policies.
  • Escalate complex or ambiguous coding issues to the appropriate coding leadership or compliance resource.

What We Offer

  • Comprehensive Health Benefits (Medical, Dental, and Vision)
  • Health Savings Account (HSA)
  • Flexible Spending Account (FSA)
  • Short & Long Term Disability
  • Holidays & Paid Time Off (PTO)
  • Employee Assistance Program (EAP)

_____________________________________________________________________________________________________________________________________________________________________________

  • Cer tain US jurisdictions require S ENTA Partners to provide new employees with a reasonable estimate of the salary for th is role at the loc a tion in which the job may be performed . Th e posted salary range reflects our best estimate at the time of posting, though it's important to remember that actual salaries may vary. Factors that determine the final salary offer include office location, experience , skills, and current organizational needs .
  • SENTA Partners is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, national origin, disability, veteran status, sexual orientation, gender identity, or any other protected status.
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