Patient Benefits Coordinator
4 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 every year since 2013 Bluestone also achieved Top Workplace USA
Position Overview:The Patient Benefits Coordinator researches, analyzes, and evaluates payer status and determines insurance coverage specifically for primary care and mental health benefits. The position will work closely with internal teams such as Enrollment, Referrals, Credentialing and Payer Contracting, and Patient Accounts team members. The Patient Benefits Coordinator will work in multiple systems, including Aprima, Insightly, eMedix and online payer portals. They are primarily responsible for researching, analyzing, and evaluating network status, eligibility, authorization requirements, exclusions, limitations, and any other requirements of the plans. The Patient Benefits Coordinator will also clearly and precisely document all relevant information to be relayed to the patient/family and verify that all data is accurate and updated for efficient claim processing. This role works remotely and provides support during our regular business hours.
This remote role must be located in one of the Bluestone Markets (Minnesota, Wisconsin or Florida).
Responsibilities:
- Work closely with the multidisciplinary team to assist with researching, analyzing, and evaluating patient insurance information specifically as it pertains to BPS, site, and all applicable care services.
- Utilize multiple EHR systems to manage workflows and queues efficiently.
- Research, analyze, and evaluate new patient insurance information, including network status, effective dates, authorization requirements, claims address, electronic payer ID, exclusions, limitations, and any other requirements of the plan for all applicable care services.
- Identify incomplete or questionable information requiring further follow-up
- Ensure the correct health plan is selected upon completion of verification as accuracy and integrity impact the workflow of each department involved in the revenue cycle process and allows for maximum reimbursement to be completed efficiently
- Confirm that claims are routed to the appropriate payer to ensure efficient and timely processing.
- Effectively communicate with internal teams, external teams, patients/POA’s, and families.
- Prioritize queues, emails, and other tasks efficiently and timely in order to meet deadlines while providing exceptional customer service to our patients and other stakeholders.
- Maintain thorough knowledge of insurance, contracts, and authorization processes.
- Collaborate with Enrollment and Payer Contracting to update the Master Insurance Tool with any insurance changes obtained through communication with insurance representatives or other stakeholders.
- Utilize insurance portals and other on-line tools for expedient and accurate retrieval of insurance benefits.
- Enter clear, accurate, detailed, and timely documentation in all applicable systems, inducing documenting all relevant information in the EHR.
- Ensure Insurance and Financial Information Integrity by performing audits of all new patient encounters to ensure that insurance information entered and updated is accurate.
- Additional duties as assigned
Qualifications:
Education/Certification/Experience
- Associates Degree or at least 2 years of equivalent administrative or customer service experience
- 2 or more years working in healthcare, insurance, and finance or similar industry
- Experience with Aprima EHR - Preferred
- Experience with Primary Care and Mental Health services - Preferred
Knowledge/Skills/Abilities
- Knowledge of In-Home & Telehealth care models is preferred
- In-depth insurance knowledge and detailed documentation is preferred
- Previous experience working closely and collaboratively with other teams on a customer’s behalf
- Dependable with good work ethic
- Excellent interpersonal and telephone communication skills
- Ability to use critical thinking skills to identify and resolve problems
- Ability to identify and prioritize urgent cases
- Ability to work independently to meet company goals and timelines
- Ability to deal with change and ambiguity
- Detail oriented and accurate
- Intermediate-level computer proficiency including Google Docs and Microsoft Office Suite
- Demonstrated compatibility with Bluestone’s mission and operating philosophies
- 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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