Director of Revenue Cycle Integrity

Salary: 156,875.00-215,690.00 :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).

• 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:
The Director of Revenue Integrity is responsible for providing strategic oversight and operational direction to employees in the department and support to departments, providers, and leadership across the organization. Is responsible for hospital and professional charge capture processes, training, education, revenue reconciliation, facilitating new and expanded business service requests, charge description master (CDM), and denials.

Responsibilities:
The director is responsible for the oversight and leadership of the revenue integrity team. Responsible for staff performance, including hiring, training, coaching and corrective actions. Provides leadership and guidance, in addition to developing goals, priorities, assigned tasks, and projects. Is the functional expert that shares information with the team, leaders, and executives across ANTHC. Prepare annual budget, strategic plan, and goals for the department. Monitors financial performance and operates within budget. Responsible for establishing performance goals and expectations for revenue integrity staff. Develop and implement revenue integrity standard work, including policies and procedures, charge reconciliation, and end-to-end charge capture analysis and workflows. Identify and monitor opportunities for timely and accurate charge capture practices. Partners with team and departments to correct variations in revenue cycle performance. Partners with departments to ensure reconciliation processes are established, being followed and implements a feedback loop for performance opportunities and variances to baseline revenue. Communicates and educates on documentation optimization efforts and charge triggers, works with departments to improve charge capture initiatives by evaluating and documenting workflows. Develops and implements new and expanded business intake, prioritization, and monitoring processes. Institutes approval mechanism and standard communication for change control. Fosters partnering relationships with the Compliance Office, Patient Access, Utilization Review, Health Information Management, Quality, Patient Financial Services, and other third parties to ensure accuracy of the CDM, fee schedules, and all charges are documented and captured. Ensures timely review of regulations such as Medicare Newsletter, Program Transmittals, ICD-10, CPT, and HCPCS guidelines. Implements and communicates necessary changes affecting ANMC Hospital and Clinic’s CDM and charge capture. Assists in the resolution of root cause analysis causing payer denials and failed system edits. Works to implement sustainable solutions to reduce denials and edits. Leads the planning, development and implementation of CDM policies and procedures. Responsible for creating standardized and compliant educational content for providers, ancillary staff, and revenue cycle teams. Engages in continuous process improvement initiatives to enhance performance and create efficiencies across the organization. Demonstrates a leadership style that is focused on improvement of processes, relationships, customers, and alignment with department and revenue cycle initiatives. Performs other duties as assigned.

Other information:

Knowledge, Skills, Abilities:

K nowledge of all aspects of healthcare revenue cycle functions including registration, coding and documentation standards, billing and collection processes, as well as government and payer regulations.

K nowledge of Alaska Tribal Health System, local, state, federal and Tribal rules, regulations, and operational guidelines and directives; and accrediting agency standards (ie: The Joint Commission, American Medical Association).

K nowledge of the various data elements associated with the UB-04 and CMS-1500 claim forms.

K nowledge of hospital and professional coding systems, including ICD-10, CPT, and HCPCS.

K nowledge of the content, structure and maintenance of the charge description master and fee schedule

K nowledge of industry standards, best practices, and software.

K nowledge of Alaska Tribal Health System, ANTHC, and Alaska Native culture(s).

K nowledge of the Privacy Act of 1974 and HIPAA Privacy Rule.

S trong quantitative, analytical, and problem-solving skills.

E xcellent oral and written communication skills with ability to effectively communicate with all levels of management.

S kill in operating a personal computer utilizing a variety of applications.

A bility to provide leadership and influence others.

A bility to foster effective working relationships and build consensus.

A bility to manage multiple priorities and tasks concurrently, meeting deadlines, and changing priorities.

A bility to develop long-range business plans and strategy.

M INIMUM EDUCATION QUALIFICATION

B achelor’s degree in finance, HIM, business, hospital administration, nursing, or other similar filed.

M INIMUM EXPERIENCE QUALIFICATION

N on-supervisory – Seven (7) years of related work experience. An equivalent combination of relevant education and/or training may be substituted for experience.

T O INCLUDE/AND

S upervisory - Three (3) years of leadership.

P REFERRED EDUCATION QUALIFICATION

N /A

P REFERRED EXPERIENCE QUALIFICATION

N /A

P REFERRED CERTIFICATION QUALIFICATION

N /A

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.

Salary : $156,875