Salary: 91,000.00-113,500.00 :USD

The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction.

ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska�s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation�s largest state.

Our vision: Alaska Native people are the healthiest people in the world.

ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:

• Medical Insurance provided through the Federal Employee Health Benefits Program as a Tribal Employee, with over 20 plans and tiers.

• Cost-Share Dental and Vision Insurances

• Discounted Pet Insurance

• Retirement Contributions with Pre-Tax or Roth options into a 403(b).

• Retirement Match and Discretionary. ANTHC matches up to 5%, with a 3% discretionary contribution after one year of employment into a 401(a).

• Paid Time Off starts immediately, earning up to 6 hours per pay period, with paid time off accruals increasing based on years of service.

• Twelve Paid Holidays

• Paid Parental Leave or miscarriage/stillbirth eligibility after six months of employment

• Basic Short/Long Term Disability premiums, Accidental Death and Dismemberment (AD&D) Insurance, and Basic Life Insurance are covered 100% by ANTHC, with additional options for Short-Term Disability Buy-Up Coverage and Voluntary Life for yourself and your family members.

• Flexible Spending Accounts for Healthcare and Dependent Care.

• Ancillary Cash Benefits for accident, hospital indemnity, and critical illness.

• On-Site Child Care Facility with expert-designed classrooms for early child development and preschool.

• Employee Assistance Program with support for grief, financial counseling, mental/emotional health, and discounted legal advice.

• Tuition Discounts for you and your eligible dependents at Alaska Pacific University.

• On-Site Training Courses and Professional Development Opportunities.

• License and certification reimbursements and occupational insurance for medical staff.

• Gym Access to Alaska Pacific University includes a salt water pool, rock climbing, workout gym, and steep discounts for outdoor equipment rentals.

• Emergency Travel Assistance

• Education Assistance or Education leave eligibility

• Discount program for travel, gym memberships, amusement parks, and more.

Visit us online at www.anthc.org or contact Recruitment directly at HRRecruiting@anthc.org.

Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.

Summary:

Under general direction of the Director of Revenue Integrity, the Revenue Cycle Charge Audit Specialist is responsible for coordinating payer audits, coordinating denials and ensuring compliant and complete clinical documentation, assist with denials and related appeals, and identify opportunities for revenue optimization. This person is responsible for investigating denials and root causes, which includes performing thorough chart reviews, providing education to clinical areas, and identifying trends.

Responsibilities:

Assists in denial management processes for Revenue Integrity department, focusing on retrospective follow-up, which may include assisting in appeal processing to maximize reimbursement based upon services delivered.

E nsures tracking of denials and all audits, identifies trends, collaborates with Revenue Cycle team, and provides education and reporting to key stakeholders.

R eviews and understands utilization review and coverage guidelines for multiple payers.

I dentifies solutions to issues affecting reimbursement as it relates to denial prevention.

C ollaborates with Revenue Cycle team on opportunities to improve and implement front-end process to support denial prevention.

C ollaborates with clinical areas to ensure accurate documentation and participates in development of action plans to ensure goals are met.

I dentifies opportunities for process improvement and participates in implementation as needed. Coordinates audits of patient medical records and itemized bills, as requested by patient, third party payer, or external auditors.

S erve as an active team member, participating in department and organization-wide initiatives.

P ositively contribute to the overall culture.

D evelop, maintain, and distribute ad-hoc reports, as needed.

P rovide support in process improvement initiatives.

D evelop and maintain a charge capture log of known opportunities and track progress.

P rovide support to ANTHC division and departments on specific projects.

P erforms other duties as assigned.

Other information:

Knowledge, Skills, Abilities:

• K nowledge of Alaska Tribal Health System, ANTHC, and Alaska Native culture(s).
• S kill in operating a personal computer utilizing a variety of applications.
• P roficiency using Microsoft Word, Excel and PowerPoint.
• S trong quantitative, analytical, and problem-solving skills.
• A bility to establish and maintain cooperative working relationships with others.
• A bility to manage multiple priorities and tasks concurrently and meet deadlines.
• A bility to communicate effectively.

M INIMUM EDUCATION QUALIFICATION

A ssociates Degree in Nursing. Progressively responsible professional work experience may be substituted on a year-for-year basis for college education.

M INIMUM EXPERIENCE QUALIFICATION

N on-supervisory � Two (2) years� experience in utilization review, case management or other revenue cycle area, to include professional work experience in health education and/or health related program development. Must have knowledge of revenue cycle and denial management functions.

M INIMUM CERTIFICATION QUALIFICATION

C urrent registered nurse license in the state of Alaska

P REFERRED EDUCATION QUALIFICATION

B achelor�s of Science in Nursing referred

A DDITIONAL REQUIREMENTS

M ay be required to work outside the traditional work schedule.

M ay be called out to work off-shift in emergency situations.

A ccording to the needs of the organization, some incumbents in this job class may be required to obtain specific technical certifications and programming language skills.