Medical Biller / Certified Coder & Auditor

Symbiotic Services•Atlanta, GA

1d•Onsite

About The Position

Symbiotic Services is recruiting for a confidential specialty healthcare client in the Atlanta, Georgia area. The Medical Biller / Certified Coder & Auditor is responsible for accurate medical coding, billing, and auditing across a complex, high-volume healthcare revenue cycle, particularly in oncology, hematology, infusion services, and specialized treatment programs. The role requires knowledge of coding guidelines, payer reimbursement policies, and compliance requirements, as well as the ability to identify discrepancies, resolve claim issues, and improve revenue cycle performance. This is described as a full-time, on-site position in a fast-paced specialty healthcare environment. The role involves high-volume coding, auditing, and revenue cycle work; regular collaboration with clinical, billing, insurance verification, authorization, and administrative teams; and independent problem-solving. Standard business hours are noted, with the specific schedule to be confirmed. Compensation, certification requirements, benefits, and other employment details are subject to final confirmation.

Requirements

Professional medical coding certification, such as CPC or an equivalent credential, is required or strongly preferred; final requirement is pending confirmation.
Experience in medical billing and coding, preferably in oncology, hematology, infusion services, or another complex specialty healthcare environment.
Strong knowledge of CPT, HCPCS, ICD-10-CM, and medical coding compliance guidelines.
Thorough understanding of E/M coding requirements, infusion administration hierarchies, and same-day billing rules.
Familiarity with Medicare LCDs, NCDs, medical necessity requirements, and commercial payer reimbursement policies.
Experience reviewing claim edits, resolving denials, correcting coding discrepancies, and supporting appeals.
Ability to manage a high volume of coding and billing responsibilities while maintaining accuracy and productivity.
Strong analytical, investigative, and problem-solving skills.
Excellent attention to detail, organizational abilities, and documentation practices.
Ability to work independently, prioritize responsibilities, and meet deadlines.
Strong communication skills and ability to collaborate with clinical and revenue cycle professionals.

Nice To Haves

Professional coding audit experience or an auditing certification, such as CPMA.
Previous coding and billing experience in oncology, hematology, infusion, or specialized treatment services.
Familiarity with blood and marrow transplant billing, global reimbursement contracts, or TPA claims.
Experience using athenahealth or similar EHR and practice management systems.
Oncology-specific coding education, certification, or specialized training.
Experience analyzing coding trends, conducting internal audits, and recommending corrective actions.
Knowledge of revenue cycle optimization, denial prevention, and payer reimbursement strategies.

Responsibilities

Assign and review CPT, HCPCS, and ICD-10-CM codes for services including E/M, infusion therapy, injections, and medication administration.
Apply coding guidelines for infusion services, administration hierarchies, and same-day E/M and infusion billing.
Assign drug-related HCPCS/J-codes and diagnosis codes in accordance with payer coverage and reimbursement requirements.
Review and apply Medicare LCDs and NCDs and commercial payer medical necessity policies.
Process and review claims involving specialized treatment programs, global billing arrangements, and TPAs.
Conduct coding and documentation audits for accuracy, regulatory compliance, and appropriate reimbursement.
Identify coding discrepancies, billing errors, denial trends, and process improvement opportunities.
Prepare audit findings and communicate recommendations to management and relevant departments.
Research, correct, and resubmit denied, rejected, or improperly processed insurance claims.
Assist with claim appeals, supporting documentation, and payer reimbursement disputes.
Monitor updates to CPT, HCPCS, ICD-10-CM, Medicare, and commercial payer coding and billing guidelines.
Use athenahealth or comparable practice management and EHR systems for billing, coding, and revenue cycle operations.
Identify system limitations and develop workflows to improve billing accuracy and operational efficiency.
Collaborate with insurance verification, prior authorization, clinical, and administrative teams to prevent billing errors and claim denials.
Maintain accurate coding records and comply with applicable healthcare regulations and organizational policies.