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Medical Coding Specialist (CPC - Required)

ENT and Allergy Associates, New York & New Jersey's premier ENT and Allergy medical practice, is seeking a self-motivated,  people-friendly full time Coding Specialist for our Corporate office.

 

  • Under the direct supervision of the Director of Regulatory Affairs, the Coding Specialist will assist in the evaluation of ENT and Allergy Associates’ (“ENTA”) medical records and claims submissions to ensure completeness, accuracy, and compliance with applicable federal and state regulations and guidelines. This individual will also provide guidance and training on medical coding to physicians and staff. 
  • The Coding Specialist must have knowledge of third party billing procedures across a variety of payer systems and have specific expertise in CPT, ICD-9/ ICD-10 and HCPCS coding for a physician group- experience in ENT and/or Allergy specialties, a plus. Must also have a working knowledge of Evaluation and Management (E&M) coding and can conduct chart reviews using the 1995 and 1997 E&M Guidelines.​  

Responsibilities & Key Tasks

Compliance 

• Assist in the oversight of compliance program and activities.
• Work closely with independent auditors and external exam teams to provide necessary support and materials necessary to test compliance programs and activities.
• Assist with establishing compliance policies in accordance with the Company’s compliance strategies and priorities, and applicable laws, regulations, and industry codes.
• Monitor, and as necessary, coordinate compliance activities, to remain abreast of the status of all compliance activities and to identify trends.

Audit 

• Audit documentation to ensure it supports complete, accurate and compliant billing with both CMS and payer requirements.
• Provide reports on all findings upon completion audits.
• Assist in the development of site and provider specific training, as well as corrective action plansbased on audit results.
• Track and trend audit results. 
• Review monthly list of refunds provided by Compliance Team to verify that a refund has been appropriately processed.
• Work closely with the Regulatory Associates to manage outside auditors.
• Assist with external audits and reviews due to coding and medical necessity by analyzing risk potential, assisting in medical record collection/submission, and appealing findings

 

Education and Experience

• Coding certifications: CPC required. CPC, CCS, CCS-P, CPMA, CEMC or CENTC); compliance certifications (CHC, CPCO) and/or Bachelor’s degree a plus.
• Two years coding experience a plus
• Experience with and exposure to compliance matters. Preference for coders with revenue management or background from the healthcare industry: hospitals, physician practices, medical billing companies, healthcare management companies. 
• Specific knowledge of the regulations and guidelines as they relate to documentation and coding.
• Superior verbal, written, organizational and interpersonal skills required. 
• Competency with Microsoft Office (Excel, Word and PowerPoint) required.
• Solid ability to organize and prioritize workload to manage multiple tasks and meet deadlines. 

 

Occasional travel to ENTA’s clinical office locations will be required.

 

We offer a superior benefits package, including excellent medical and dental coverage. 

Please Note:  ENT and Allergy Associates is an E-Verify employer

 

Company Description:

ENT and Allergy Associates, LLP is the largest and most comprehensive ear, nose, throat, allergy and audiology practice in the nation with 40 offices and over 150 physicians. Each ENT and Allergy Associates clinical location provides access to a full complement of services, including General Adult and Pediatric ENT, Voice and Swallowing, Facial Plastics and Reconstructive Surgery, Disorders of the Inner Ear and Dizziness, Asthma, Clinical Immunology, Diagnostic Audiology, Hearing Aid dispensing, Sleep and CT Services. ENTA has a clinical alliance with The Mount Sinai Hospital for the treatment of diseases of the head and neck and esophageal cancer and a partnership with the American Cancer Society to educate and treat patients with smoking disorders and cancer. The Practice has also expanded its clinical capabilities to include advanced Immunodeficiency trials.

To learn more about the benefits of ENT and Allergy Associates, or to conveniently find an ENT doctor or Allergy Doctor and then easily book an appointment at the nearest New York or New Jersey location, please visit: www.entandallergy.com or contact us at:

ENT and Allergy Associates, LLP
560 White Plains Road, Suite 500
Tarrytown, NY 10591

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