Coding Specialist providing CPT and Diagnosis codes for Outpatient Facility SDS Charts

This role involves performing revenue cycle duties such as advocating for patients, assisting with primary insurance updates, ensuring timely claim submissions, and collecting outstanding patient balances. Daily tasks include communicating with patients and insurance payers regarding coverage and reimbursement for dialysis services.

The Care Navigator provides ongoing proactive patient services through monthly calls, reviewing health status, escalating concerns, and providing education related to medical conditions and health goals. Key duties involve consistent patient check-ins, detailed documentation, care coordination across providers, and achieving monthly call goals.

This position involves submitting and resolving medical claims of moderate to high complexity for inpatient and outpatient services, ensuring compliance with governmental and third-party billing requirements. Responsibilities include utilizing worklists to analyze account balances, communicating with various parties to resolve inquiries, and documenting account actions clearly.