Director, Revenue Cycle Management & Credentialing

Bluestone Physician Services - Stillwater, MN

Full-time
Bluestone has been named to the Star Tribune's Top Workplaces in MN, making the list 7 years in row!

Bluestone Physician Services provides expert, on-site care to members in assisted living communities in Minnesota, Wisconsin and Florida. We provide geriatric primary care, care coordination, integrated care, and psychiatric services.

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.

As the Director, Revenue Cycle Management & Credentialing you will be responsible for developing departmental budgets, ensuring successful account adjudication and exceptional collections while promoting a high level of customer service across the revenue cycle. The director should actively encourage relationships with health plans and government payers to improve payment performance and relationships. The director will coordinate all functions of the revenue cycle in a manner that complies with the standards established by leadership, outside regulatory and accreditation agencies, and performs duties in a manner that promotes a single Revenue Cycle team.

The Revenue Cycle Director is expected to deliver a consistent standard of excellence which all departmental work is expected to reflect. Such a standard should be focused on continuous improvement within the director's area of influence, and deliver the highest degree of quality service.

Additionally, the director is responsible for the credentialing function which is responsible for timely credentialing of all providers with health plans and government payers.

RESPONSIBILITIES

System Patient Access: Pre-registration, registration, insurance verification, authorization, and point-of-service collections.
System Patient Financial Services: Billing, collections, transaction posting, payment variances, system denial prevention, and vendor management
Customer Revenue Cycle: Self pay collections and customer service
Project management within the medical billing department
In-depth knowledge and experience with full claims processing
Developing meaningful management reports
Electronic/EDI billing, and resubmission of claims and remittance
Claims follow through for all insurance plans, managing denials, resubmissions, and tracking
Analyzing insurance contract terms and conditions regarding claims submission and resubmission timelines
Oversee and manage activities of the provider enrollment process ensuring compliance with provider enrollment policies and procedures

QUALIFICATIONS/REQUIREMENTS

Bachelor's degree in Business, Finance or related field
7-10 years of experience managing medical billing department
Experience with eClinicalWorks or Aprima preferred
Experience with process improvement or project management
Knowledge of ICD-9, CPT, HCPCS codes and claim regulatory guidelines
Working knowledge of Medicare, Medicaid, and third party insurance
Ability to anticipate future consequences and trends accurately, has broad knowledge and perspective and excellent conceptual and planning skills
Excellent decision skills based upon a mixture of analysis, wisdom, experience and judgment
Ability to make timely decision with incomplete information
Demonstrated ability to achieve results through managing others
Strong interpersonal and technical skills
Skill in identifying and resolving problems
Demonstrated compatibility with Bluestone's mission and operating philosophies
Strong working knowledge of enrolling and/or credentialing physicians, knowledge of managed care and governmental entities (Medicare/Medicaid)

Bluestone offers excellent benefits to our employees including:

Competitive wages
Health Insurance
Dental Insurance
Company paid Life Insurance
Company paid Short and Long-term Disability
Health Savings Account (HSA)
Flexible Spending Account (FSA)
Retirement plan with 4% matching contributions
Three weeks Paid Time Off (PTO)
Nine paid (non-working) holidays
Regular business hours; no evenings or weekends
Mileage reimbursement

By working here, you have the chance to make a difference in the lives of others. Our success has translated into a rapidly-growing organization, offering career opportunities in recognition of hard work. To find more information about exciting opportunities within our innovative and ever-growing organization, please visit www.bluestonemd.com #ZR

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