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
- 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.
- 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.
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 Denials Analyst will bring a deep understanding of payer denial trends, claims processing strategies, and accounts receivable resolution tactics to reduce claims denials and increase revenues through process improvement, root cause analysis, and development of metrics and reports. The role will focus on denial prevention by collaborating with clinical teams, insurance payers, and the Revenue Cycle team to identify denials issues and trends and develop process improvement plans.
Responsibilities:
Denial prevention – Identify denial trends, provide documentation, data, and reporting to Revenue Cycle leadership and key stakeholders. Perform root cause analysis and offer recommendations for process improvement.
Regularly track and analyze denial data to identify, recommend, and implement opportunities to optimize revenue and reimbursement for the organization.
Analyze and review third-party payer denials of claims and develop and implement strategies to reduce denials system-wide.
Identify trends that impact payment optimization and collaborate with various departments to establish action plans, initiatives, and policies to decrease denial trends.
Research applicable regulatory, coding, and billing rules and educate departments on regulations, processes, and medical necessity requirements.
Identify revenue opportunities and provide appropriate investigation, follow-up, and resolution. Analyze trends and inefficiencies in charges and recommend operational improvements in an effort to prevent incorrect payments and denials.
Complete monthly denial reporting and communicate trends and data to operational areas for review and provide follow up support to operational areas to reduce denials.
Identify and communicate system issues related to denials stemming from billing, edits, rejections, and follow-up work queues with Revenue Cycle team.
Independently conduct meaningful analysis to investigate trends in denial write-off data to aid in the identification and prioritization of denial prevention initiatives.
Provide support in review of complex cases and assist in appeals involving authorization, medical necessity, COB, and other denials.
Support the development, implementation, and evaluation of existing policies and procedures related to denials management.
Submit optimization tickets with the Analytics team to resolve issues, support in testing and training as necessary.
Serve as an active team member, participating in department and organization-wide initiatives.
Positively contribute to the overall culture.
Develop, monitor, and follow up of denial metrics within the revenue cycle.
Develop, maintain, and distribute ad-hoc reports, as needed. Provide support in process improvement initiatives.
Develop and maintain a denials issues log of known opportunities and track progress.
Provides support to ANTHC division and departments on specific projects.
Performs other duties as assigned.
Other information:
Knowledge, Skills, Abilities:
- Knowledge of Alaska Tribal Health System, ANTHC, and Alaska Native culture(s).
- Skill in operating a personal computer utilizing a variety of applications.
- Proficiency using Microsoft Word, Excel and PowerPoint.
- Strong quantitative, analytical, and problem-solving skills.
- Ability to establish and maintain cooperative working relationships with others.
- Ability to manage multiple priorities and tasks concurrently and meet deadlines.
Ability to communicate effectively.
MINIMUM EDUCATION QUALIFICATION
Associate's degree in a health-related field. Progressively responsible professional work experience may be substituted on a year-for-year basis for college education.
MINIMUM EXPERIENCE QUALIFICATION
Non-supervisory – 2 years of work experience. An equivalent combination of relevant education and/or training may be substituted for experience.
Minimum 2 years of healthcare experience working with billing, Charge Description Master (DM), or denials management.
