Revenue Cycle Specialist
3 weeks ago
Bluestone Physician Services’ unique, robust model of care goes beyond primary care services. Our model is tailored to patients living with multiple chronic conditions and disabilities. Bluestone recognizes that patients need a customized approach to care that is preventative, proactive and includes all members of the care team. Medical providers, nurses and social workers collaborate with patients’ other healthcare providers and families.
Our Care Model delivers customized care that is preventive, proactive, and includes all members of the care team, patients and their families. Our patients experience 21% less ER visits, 36% less hospitalization and 41% less hospital re-admissions compared to patients with similar conditions and complexities.
Bluestone has locations in Minnesota, Wisconsin, Florida and uses a mobile clinic approach to provide care to patients within Assisted Living, Memory Care, and Group Home Facilities.
At Bluestone, our employees are our most valuable asset. We know our success is only possible through the hard work and dedication of each of our employees.
Bluestone has been named to the Star Tribune's Top Workplace list for the 11th year in a row Bluestone also achieved Top Workplace USA 2021-2024
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.
This remote role MUST be located in our markets in Minnesota or Florida.
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
Education/Certification/Experience
- Previous data entry and 10-key experience required
- 2 years of previous medical billing experience in a provider setting preferred
- Knowledge of basic accounting concepts
- General understanding of medical insurance products and plans
- Knowledge of ICD-9, 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 paid holidays for office closures plus two floating holidays
- Three weeks (15 Days) Paid Time Off (PTO)
- Company sponsored laptop and computer accessories
- Regular business hours
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