ANMC Pharmacy Billing Specialist I/II - DOE

Salary: Negotiable :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).

• 401(a) ANTHC Retirement Plan: After one year of employment, ANTHC will begin making matching contributions of up to 5% of your eligible pay, based on your own contributions. In addition, you may be eligible for an annual discretionary contribution of up to 3% from the employer.

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

• Eleven 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 close supervision, prepares and submits insurance claims; reviews and adjusts accounts to ensure accurate and thorough billing of claims at the Alaska Native Tribal Health Consortium (ANTHC) and the Alaska Native Medical Center .

Responsibilities:

All:

P repares and submits insurance claims to all third party payers for all patients who receive Pharmacy care from both ANTHC and SCF providers. Reviews electronic health record to determine billable charges. Reviews all claims before submission to insurance companies. Maintains file system for billed claim records and back up for audit purposes. Verifies coverage and follows up on submitted claims. Requests corrected diagnosis for reimbursement purposes from physicians and mid-levels. Responds to inquiries from patients, physicians, insurance companies regarding covered charges, remittance advices, and billing questions. Screens calls and visitors to determine the nature of the visit or phone call and the urgency of the contact to ensure a timely, efficient, and appropriate response. Works with Medicaid, Medicare, and secondary insurance companies for submission of claims, to verify coverage, determine status of claims and resolve issues with the claims. Answers incoming phone calls and reviews incoming correspondence and materials. Maintains a variety of files, logs, and registers. Prepares or assists in the preparation of monthly reports. Reviews insurance information in computer registration to determine accuracy. Ensures that equipment is functional and there is an adequate supply of all necessary forms stocked. Facilitates and follows-up on repair orders for maintenance. Performs other duties as assigned.

P harmacy Billing Specialist II

P erform complex and responsible tasks within this position and generally work with minimum supervision and follow-up from their supervisor.

P harmacy Billing Specialist III

P erform high level, complex and responsible tasks within this position and generally work with minimum supervision and follow-up from their supervisor.

P harmacy Billing Specialist IV

W orks with management in the maintenance, upkeep and distribution of billing policies, procedures, guidelines and standards. Works with insurance companies to optimize reimbursement by completing applications and understanding reimbursement policies of each third party. Assists in the orientation of new clerical staff teaching those computer processes involved in collecting accurate information to ensure timely reimbursement. As requested, participates in general or special assignments. Provides leadership, direction, and guidance to staff. Develops goals and priorities in conjunction with manager and employees, and assigns tasks and projects. Develops staff skills and training plans and oversees training and competency.

Other information:

KNOWLEDGE and SKILLS

A ll

K nowledge of medical billing and accounting procedures and applications.

K nowledge of commercial insurance and government reimbursement programs.

K nowledge of basic medical terminology and clinic systems.

K nowledge of reception, typing, computer operations, and filing procedures.

K nowledge of customer service concepts and practices.

S kill in operating a personal computer utilizing a variety of software applications, including medical billing programs.

S kill in tracking multiple projects.

S kill in establishing and maintaining cooperative working relationships with other employees.

S kill in conducting successful telephone consultations and operating a complex phone system.

M INIMUM EDUCATION QUALIFICATION

A ll

A high school diploma or GED equivalent.

M INIMUM EXPERIENCE QUALIFICATION

P harmacy Billing Specialist I

N on-supervisory - None

P harmacy Billing Specialist II

N on-supervisory - One (1) year of pharmacy billing experience. An equivalent combination of relevant education and/or training may be substituted for experience.

P harmacy Billing Specialist III

N on-supervisory – Three (3) years professional experience at Alaska Native Medical Center (ANMC) Pharmacy or related experience.

P harmacy Billing Specialist IV

N on-supervisory – Five (5) years professional experience at Alaska Native Medical Center (ANMC) Pharmacy or related experience.

M INIMUM CERTIFICATION QUALIFICATION

A ll

C urrent Pharmacy Technician License required.

P harmacy Billing Specialist I

M ust obtain Pharmacy Technician Certification Board (PTCB) certification within one year of employment. With prior approval from Pharmacy Manager, PTCB certification may be extended beyond 1 year of employment if actively enrolled in a Pharmacy Technician Apprenticeship Program or pharmacy technician training course.

P harmacy Billing Specialist II, III, and IV

P harmacy Technician Certification Board (PTCB) Certification – Required on hire.