Medical Billing & Coding Coordinator Ear Nose & Throat Surgeons of Western New England LLC Springfield, MA Job Details Full-time $79,000 - $86,000 a year 13 hours ago Benefits Health savings account Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Retirement plan Qualifications Medicare Managed care Medical Coding Certification Certified Professional Coder Certified Coding Specialist Documentation review Full Job Description Job Summary

POSITION SUMMARY

The Medical Billing Coordinator is responsible for day-to-day professional billing operations for ENTS, including claim review and submission, coding validation, billing correspondence, claim holds, unpostables, hospital consult billing, payer issue resolution, reporting, and billing workflow support. This role requires an active coding certification and works closely with the Manager of Revenue Cycle and operational teams to ensure claims are accurate, compliant, and submitted timely.

ESSENTIAL DUTIES & RESPONSIBILITIES

Process billing mail, payer correspondence, requests, and other billing-related documentation received by the office. Review claims for coding, documentation, modifiers, diagnosis linkage, rendering provider, place of service, referral, authorization, and payer-specific requirements before submission including denials and appeals management. Submit, correct, and resubmit claims to commercial, Medicare, Medicaid, managed-care, and other payers. Work assigned billing hold buckets, claim edits, missing-charge items, and other work queues to support timely claim release. Coordinate through Teams and established workflows with Referrals Coordinator, Authorizations Team, Front Desk, Clinical, Surgical, and other staff when claims require correction or additional information. Process professional billing for hospital rounding, inpatient/observation consults, emergency services, and other hospital-based encounters. Work unpostables and payment-posting exceptions and assist in resolving the underlying billing or payer issue. Run and review billing, claim, productivity, and operational reports as requested, including month-end reporting as requested by ENTS. Research payer policies, coding edits, bundling rules, medical necessity requirements, Credentialing related claim issues, and reimbursement issues; collaborate with the Manager of Revenue Cycle on payer strategy. Assist with development, maintenance, and implementation of billing SOPs and staff education related to billing workflow changes. Identify recurring billing errors, denial trends, or workflow breakdowns and escalate them with recommended corrective action. Perform other billing, coding, claim, reimbursement, or revenue cycle duties necessary to support ENTS operations.

QUALIFICATIONS

Active coding certification required (CPC, CCS, CCS-P, COC, or equivalent recognized credential). Minimum 2 years of professional medical billing/coding experience preferred; ENT and surgical billing experience strongly preferred. Working knowledge of CPT, ICD-10-CM, HCPCS, modifiers, global surgery rules, payer edits, referrals, authorizations, and professional claim submission. Experience with Athenahealth or a comparable practice-management/billing system preferred. Strong organizational, analytical, communication, and problem-solving skills; ability to manage multiple priorities independently.

PERFORMANCE STANDARDS

Claims are reviewed and released accurately and within departmental turnaround standards. Assigned hold buckets, unpostables, and billing work queues are maintained with minimal avoidable aging. Coding and claim corrections are supported by documentation and applicable payer/coding guidance. Referral and authorization issues are communicated promptly to the responsible team and followed through to resolution. Recurring payer, denial, or workflow trends are identified and escalated to the Director of Revenue Cycle. Billing SOPs and assigned reports are completed accurately and on schedule. Maintains confidentiality, compliance, professional communication, and consistent adherence to ENTS policies. Join us as a Medical Billing & Coding Coordinator to play a crucial role in supporting efficient healthcare delivery through precise coding practices and seamless billing operations!

Pay:

$79,000.00 - $86,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Health savings account Paid time off Retirement plan Vision insurance

Work Location:

In person