Job Information
Bluestone Physician Services Medical Coding Specialist (Remote in MN, WI or FL) in Stillwater, Minnesota
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 (https://bluestonemd.com/2023/09/bluestone-aco-delivers-excellent-care-to-medically-complex-elderly-patients-saves-medicare-26-6-million/) as measured by the overall savings per Medicare beneficiary.
Position Overview :
The Medical Coding Specialist role is responsible for ensuring that patients are billed correctly for their care and that the business receives proper reimbursement for services provided. They are responsible for the completeness, accuracy, and compliance of all coding assignments prior to claim submission, as well as taking appropriate steps to correct all denied claims. They will support clinicians with ongoing guidance on coding best practices based on established regulatory standards as needed.
Schedule: Full time position, day shift hours, no evenings, weekends or holidays.
Location: Remote (work from home). Candidates for this remote role must be located in one of Bluestone Markets (Minnesota, Wisconsin or Florida).
Salary: $25.00-28.00 hourly. Base salary will be commensurate with experience.
Responsibilities :
Conduct prospective review of clinical documentation and reimbursement claims for government programs (Medicare and Medicaid) to ensure documentation, diagnosis and procedural codes accurately reflect and support provider services, in accordance with legal standards and guidelines
Interpret medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM, CPT and/or HCPCS codes
Document errors and areas for improvement regarding clinical documentation and coding for assigned providers
Review claim edits to determine appropriate action. Make necessary changes to claim form to ensure accurate code assignment prior to claim submission
Provide technical guidance to providers in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines
Review denied claims to determine appropriate action. Initiate corrections or provide support for appeal, as necessary
Attend clinic and department staff meetings to disseminate information and to become familiar with operational issues within each business unit
Collaborate with manager in the development and improvement of work flow processes, for optimum output/efficiency
Read bulletins, newsletters, and periodicals and attend workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation
Promote an atmosphere of open communication, team work and staff input in the decision-making process
Assist coding supervisor in orienting, training, and mentoring staff
Participate in completion of special projects as assigned by coding supervisor
Qualifications :
Education/Certification/Experience
Current Medical Coding Certification required
Strong E/M coding experience preferred
Hierarchical Condition Category (HCC) experience preferred
Medical billing experience a plus
Knowledge/Skills/Abilities
Knowledge of:
Medical terminology and understanding of patient care notes
ICD-10-CM, CPT, and HCPCS Coding systems
Health information and medical record documentation, data integrity and quality
Medicare, Medicaid and other third-party payer reimbursement
State and Federal laws governing billing and coding practices
HIPAA regulations
Maintains an expert level of knowledge of coding related guidelines and practices
Solid knowledge and understanding of clinical criteria documentation requirements used to successfully substantiate code assignments
Proficient in Medicare and CMS guidelines
Computer proficiency including ability to navigate electronic medical records system, Google Business Suite, and equipment such as iPhone and iPad
Excellent organizational skills with the ability to prioritize tasks and work in a fast-paced environment
Strong desire to learn
Strong attention to detail, follow-through, and commitment to quality
Work independently and proactively to meet company goals and timelines with minimal direction/supervision
Ability to positively interact with physicians, providers and staff
Strong written and verbal communication skills
Skilled in identifying and resolving problems
Ability to deal with change and ambiguity
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 (8) paid holidays for office closures plus two (2) floating holidays per year
Three weeks (15 Days) Paid Time Off (PTO)
Mileage reimbursement program for field employees
Company sponsored cell phone and laptop
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