Pay Range:
Pay Range:$31.83 - $44.56 Responsible for improving the charge capture, reimbursement, and quality of the revenue cycle through the support and management of revenue cycle applications; process automation, Charge Description Master, Claims, analysis, reporting, clinical and departmental integration, and performance of compliance, contract payment, and denials auditing.SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.
Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.
Key Essential Functions and Accountabilities of the Job
Optimization and troubleshooting of revenue cycle applications
Collaboration with clinical, operational, supporting departments, applicable stakeholders, for development of integrated design solutions
Analysis of available data to support Revenue Cycle team initiatives in identification, definition, resolution planning, and implementation for system & user deviations, inconsistencies, and process failures
Serves as an internal resource on a combination of the topics of registration, authorizations, coding, CDI, CDM management, claims, edits, billing compliance, denials, remittance processing, and/or reporting & analytics
Workflow analysis
Payer contract analysis and ensuring payments consistent with negotiated contracts
Identification of root causes of issues driving controllable denials, partnering with finance leadership to address implicated operational issues, workflow issues, and training gaps
Performs quality assurance and validation tasks
Provides education and guidance to patient revenue generating departments/providers to ensure appropriate charge capture
Education, Certifications, and Licenses Required
Bachelor's degree or an equivalent combination of education and/or work experience – Required
4 years of work experience may be exchanged for a bachelor's degree
AAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure - Preferred
Experience Required
2 years of experience Revenue Cycle, Finance, or Clinical capacity
Knowledge of
End user workflows including scheduling, registration, clinical, ancillary, coding, billing and claims processing, cash posting, and/or reporting
National and International code sets including ICD 10CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, NCCI
Payer edits, rejections, rules, and appropriate actions and requirements for resolution
Billing, accounts receivable, collection practices, and/or reporting requirements for IHS, CAH, FQHC, Provider Based, LTC, Rehab, Behavioral Health (CBH, SUD, 1115), and/or Retail Pharmacy enrollments
File structure, configuration, requirements, and troubleshooting of UB 04, CMS 1500, 837I/P, 835, and/or NCPDP D.0
Resources, references, statutes, governing the instruction, policy, and procedure for participation in, and billing, for various State, Federal, and Commercial programs
Skills in
Critical thinking (problem solving, troubleshooting)
Creative solution design and execution for complex problems
Exposure to Microsoft Office programs, including Word, Excel
Electronic Health Record applications
Ability to
Work on different projects simultaneously, multitasking in a fast-paced environment, appropriately handle overlapping commitments and deadlines
Implement a systematic, self-motivated approach to problem solving
Work independently and collaboratively as needed
Required Certifications:
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
Skills Required
- Bachelor's degree or equivalent combination of education and work experience
- Four years of work experience may substitute for a bachelor's degree
- Two years of experience in revenue cycle, finance, or a clinical capacity
- Knowledge of healthcare revenue-cycle workflows, including registration, coding, billing, claims processing, cash posting, and reporting
- Knowledge of ICD-10-CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, and NCCI code sets
- Knowledge of payer edits, rejections, billing, accounts receivable, collections, and claims requirements
- Knowledge of UB-04, CMS-1500, 837I/P, 835, and/or NCPDP D.0 file structures and requirements
- Critical thinking, problem-solving, troubleshooting, and complex solution design skills
- Exposure to Microsoft Office, including Word and Excel
- Experience with electronic health record applications
- AAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure
What We Do
For nearly 50 years, SEARHC has provided high-quality healthcare services to the residents of Southeast Alaska. Operating as an independent and nonprofit health Consortium, SEARHC provides a comprehensive range of health-related services, including primary, urgent and specialty medical care, dental services, behavioral health support, wellness programs, optometry services and more. We are dedicated to improving the health, well-being and quality of life for all people in these communities. SEARHC is committed to keeping care closer to home and making advanced medical technologies accessible to all. One of the many ways SEARHC does this is by offering specialty clinics or sending medical specialists to remote communities and facilities to care for patients who cannot travel. Established in 1975, SEARHC is one of the largest Native-run health organizations in the United States. In 1976, SEARHC contracted with the Indian Health Service under the Indian Self-Determination and Education Assistance Act to assume management of the Community Health Aide Program. Today, SEARHC has more than 1,700 employees and operates in 27 communities throughout Southeast Alaska, including two Critical Access Hospitals.
