Charge Services Manager (Remote)

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.

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 facilitates continuous revenue cycle process improvement within the Charge Services and CDM for Patient Financial Services.

Responsibilities:

Focusing on the integrity of charges and other data, improving workflows and providing education across the organization in order to ensure that we capture revenue appropriate for the services we provide to our patients.

Evaluates charging and coding structures, as well as processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third party payer requirements. Identifies gaps in process that contribute to missed, inaccurate, or late charges.

Improves department processes and procedures to assure timely and accurate capture of all chargeable activities. Identifies and assists with establishing controls ensuring compliance and achievement of financial goals (i.e. appropriate internal controls).

Collaborates with peers to administer Charge Description Master (CDM) and related audits with a focus on revenue cycle integrity. Assessing the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents. Analyzes billing error and denial data to identify root causes.

Works with other Revenue Cycle Managers to create work plans to correct identified issues. Executing on work plans to adapt systems and processes to accommodate changes. Develops, maintains and implements Revenue Integrity and charge capture policies, procedures and training materials. Provides guidance, communication and education on correct charge capture, coding and billing processes to multiple clinical departments and facilities.

Leads and participates in complex projects related to revenue integrity initiatives collaborating with Compliance, Finance, Patient Financial Services, Health Information Management & Clinical Departments as needed. Develops charge reconciliation processes to assure that all charges are entered for patients treated in clinical areas of the health system. Educates clinical staff on charge capture process and performs audits to ensure standard work remains in place.

Keeps abreast of changing industry requirements and regulations regarding acceptable documentation and billing practices by reviewing Federal Register, fraud alerts, OIG advisory opinions and other relevant publications. Communicates changes to impacted leaders and provides education on such changes.

Reviews, analyzes and resolves accounts that have failed coding and charging related claim edits, including medical necessity, National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), Medically Unnecessary Edits (MUE), and other exceptions requiring clinical/coding expertise. Works closely with Revenue Cycle teams to resolve rejections and denials.

Performs other duties as assigned.

Other information:

KNOWLEDGE and SKILLS

Knowledge of privacy laws and regulations including health care compliance laws and regulations.

Knowledge ICD-10 coding, CPT coding, and advanced medical terminology

Knowledge and experience of a broad base of health care reimbursement and billing principles.

Knowledge of physician practice operations and physician practice reimbursement principles.

Knowledge of hospital operations and ANMC Policy & Procedures, in order to ensure policies are followed.

Knowledge of Cerner Millennium Patient Accounting and Charge services tools

Skill in customer service concepts and principles.

Skill in establishing and maintaining cooperative working relationship with others.

Skill in assessing and prioritizing multiple tasks and facilitating projects and work teams.

Skill in analytical, oral, and written communication as well as analysis and presentation.

Skill in high level revenue cycle information technology.

Skill in project management including ability to bring projects in on time and under budget.

Skill in presenting financial and process information to boards, physicians and executives.

Skill in effectively managing staff, mentoring staff, delegating tasks and delegating authority.

Skill in developing departmental policies and procedures.

MINIMUM EDUCATION QUALIFICATION

Bachelor’s Degree in Business / Healthcare related field or eight years of equivalent, related work experience. Progressively responsible professional work-related experience, education, or training may be substituted on a year-for-year basis for college education.

MINIMUM EXPERIENCE QUALIFICATION

Non-supervisory – Six (6) years of medical finance or business office or related revenue cycle experience, including substantial experience as a “super user” of financial information systems and health care financial management or revenue cycle management or business office management experience.

AND

Supervisory – Two (2) years involving employee supervision.