Medical Biller / Certified Coder & Auditor

Symbiotic Corp.; Atlanta (GA); On-site; USD 60,000 - 80,000; Full time

Job summary

Symbiotic Services, LLC is seeking an experienced Medical Biller / Certified Coder & Auditor for a confidential client in the Atlanta, GA area. This role focuses on accurate coding, billing, and auditing across a high-volume revenue cycle in oncology and related specialties.

You will work on CPT/HCPCS/ICD-10-CM coding, same-day billing, LCDs/NCDs, and payer policies, using athenahealth or similar EHR systems.

Qualifications

• Professional medical coding certification such as CPC required or strongly preferred.
• Experience in medical billing and coding, preferably within oncology, hematology, infusion services, or another complex specialty healthcare environment.
• Strong knowledge of CPT, HCPCS, ICD-10-CM and coding compliance guidelines.
• Thorough understanding of evaluation and management (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.

Responsibilities

• Assign and review CPT, HCPCS, ICD-10-CM codes for services incl E/M.
• Apply coding guidelines for infusion services and same-day billing.
• Ensure correct drug HCPCS/J-codes per payer rules.
• Review LCDs/NCDs and payer medical necessity policies.
• Audit coding and documentation for accuracy and compliance.
• Identify denials and opportunities for process improvement.
• Prepare audit findings and communicate recommendations.
• Research and resubmit denied or improperly processed claims.
• Support claim appeals and payer disputes.
• Collaborate with verification, auth, clinical and admin teams.

Skills

Attention to detail

Analytical thinking

Communication skills

Independent worker

Problem solving

Ownership

Education

CPC certification (or equivalent)

Tools

Athenahealth

EHR/Practice Management systems

Job description

Job Information

Medical Biller / Certified Coder & Auditor Presented by Symbiotic Services, LLC Location: Atlanta, GA Area | On-Site Employment Type: Full-Time (Pending Confirmation)

Position Overview

Symbiotic Services is seeking an experienced, detail-oriented Medical Biller / Certified Coder & Auditor for a confidential client in the specialty healthcare industry in the Atlanta, GA area. This position will be responsible for accurate medical coding, billing, and auditing across a complex, high-volume healthcare revenue cycle, with a particular emphasis on oncology, hematology, infusion services, and specialized treatment programs. The ideal candidate possesses extensive knowledge of medical coding guidelines, payer reimbursement policies, and compliance requirements, along with the ability to identify billing discrepancies, resolve claim issues, and optimize revenue cycle performance. This opportunity is well suited for a certified coding professional who thrives in a fast-paced environment, demonstrates strong analytical abilities, and takes ownership of coding accuracy and billing efficiency.

Key Responsibilities

• Accurately assign and review CPT, HCPCS, and ICD-10-CM codes for medical services, including evaluation and management (E/M), infusion therapy, injections, and medication administration.
• Apply appropriate coding guidelines for infusion services, administration hierarchies, and same-day E/M and infusion billing.
• Ensure accurate assignment of drug-related HCPCS/J-codes and diagnosis codes in accordance with payer coverage and reimbursement requirements.
• Review and apply Medicare Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and commercial payer medical necessity policies.
• Process and review claims involving specialized treatment programs, global billing arrangements, and third-party administrators (TPAs).
• Conduct comprehensive coding and documentation audits to ensure accuracy, regulatory compliance, and appropriate reimbursement.
• Identify coding discrepancies, billing errors, denial trends, and opportunities for process improvement.
• 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.
• Utilize athenahealth or comparable practice management and electronic health record systems to support billing, coding, and revenue cycle operations.
• Identify system limitations and develop practical 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 ensure compliance with applicable healthcare regulations and organizational policies.

Requirements

• Professional medical coding certification, such as Certified Professional Coder (CPC) or an equivalent credential, required or strongly preferred (final requirement pending confirmation).
• Demonstrated experience in medical billing and coding, preferably within 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 evaluation and management (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 the ability to collaborate with clinical and revenue cycle professionals.

Preferred Qualifications

• Professional coding audit experience or an auditing certification, such as Certified Professional Medical Auditor (CPMA).
• Previous experience coding and billing oncology, hematology, infusion, or specialized treatment services.
• Familiarity with blood and marrow transplant billing, global reimbursement contracts, or third-party administrator (TPA) claims.
• Experience using athenahealth or similar electronic health record (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.

Ideal Candidate Profile

• Coding Accuracy and Expertise: Maintains exceptional attention to detail and applies complex coding guidelines consistently and accurately.
• Analytical Thinking: Identifies discrepancies, investigates claim issues, and develops effective solutions to coding and reimbursement challenges.
• Initiative and Ownership: Proactively addresses billing problems, identifies opportunities for improvement, and follows issues through to resolution.
• Adaptability: Works effectively in a dynamic healthcare environment where payer requirements, processes, and priorities may change.
• Efficiency and Productivity: Manages high-volume workloads while maintaining accuracy, compliance, and timely claim processing.
• Continuous Learning: Stays informed about evolving coding guidelines, reimbursement regulations, and industry best practices.
• Team Collaboration: Communicates effectively with clinical staff, insurance specialists, billing teams, and organizational leadership.
• Professionalism and Compassion: Recognizes the importance of accurate billing and reimbursement in supporting quality patient care.

Work Environment

Full-time, on-site position in the Atlanta, GA area. Fast-paced specialty healthcare environment with complex billing and coding requirements. Regular collaboration with clinical, billing, insurance verification, authorization, and administrative departments. High-volume coding, auditing, and revenue cycle responsibilities requiring accuracy, efficiency, and independent problem-solving. Standard business hours; specific schedule to be confirmed.

Compensation & Benefits

Employment Type: Full-Time (pending confirmation). Benefits: Details to be provided during the recruitment process.