Job Description

Job Description

Job Description

Bluestone Physician Services delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services — our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs.

Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients’ chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period. 

Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida.

Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 12th year in a row! Bluestone also achieved Top Workplace USA 2021-2024! In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary.

Position Overview:

Under the supervision of the Revenue Cycle Manager, the Revenue Cycle Specialist performs duties related to full claims processing from submission through payment. This includes but is not limited to: submission of claims, follow-up for all insurance plans, managing denials, resubmissions, and tracking of special exceptions, as well as managing patient balances. This position will primarily be communicating with insurance carriers, customers, and co-workers.

Schedule: Full time position, day shift hours, no evenings, weekends or holidays.

Location: This remote role MUST be located in our markets in Minnesota, Wisconsin or Florida. 

Salary: $23.00 - $27.00 per hour. Salary will be commensurate with experience.

Responsibilities:

• Review and resolve all claims errors before claim is submitted for payment
• Review and effectively troubleshoot all known claim denials and rejections, follow up with insurance providers regarding unpaid and rejected claims; resolve issues and re-submit claims
• Review and process credit refunds for patient and insurance overpayments
• Answer phone inquiries regarding billing, insurance, and claims
• Contact patients, patient families, and/or POAs to obtain accurate/updated insurance information
• Actively manage and resolve aging claims
• Actively work to resolve individual patient balances including contacting patients to set up payment plans, taking credit card payments, and sending electronic communications
• Collaborate with field management teams on data analysis and account resolution regarding aging reports
• Other duties as assigned

Qualifications:

Education/Certification/Experience

• Previous data entry and 10-key experience required
• 2 years of previous medical billing experience in a provider setting preferred

Knowledge/Skills/Abilities

• Knowledge of basic accounting concepts
• General understanding of medical insurance products and plans
• Knowledge of ICD-10, CPT, HCPCS codes and claim regulatory guidelines
• Knowledge of medical terminology
• Working knowledge of Medicare, Medicaid, and third party insurance and the rules and regulations that apply
• Strong computer skills, including Microsoft Excel and Google Sheets
• Comfortable navigating electronic medical records
• Skill in completing multiple tasks at once
• Skill in identifying and resolving problems
• Skill in verbal and written communication
• Ability to communicate professionally with supervisors, coworkers, customers, and patients
• Ability to work independently as well as a member of a team to meet company goals
• Detail oriented and accurate
• Demonstrated ability to read, write, speak, and understand the English language

Bluestone Benefits:

• Health Insurance
• Dental Insurance
• Vision Materials Insurance
• Company paid Life Insurance
• Company paid Short and Long-term Disability
• Health Savings Account (with employer contribution)
• Flexible Spending Account (FSA) 
• Retirement plan with 4% matching contributions
• Eight (8) paid holidays for office closures
• Three weeks (15 Days) Paid Time Off (PTO)
• Regular business hours

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