Charge Analyst

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

Job Description

Summary:

This position is responsible for the proactive management of the charge masters and fee schedules for Ohio Health hospital operations covering 1000+ departments at all hospitals with patient charges of $15+ billion annually. The incumbent is responsible to ensure that the charge masters are in compliance with rules and regulations for participation in governmental programs, meet the contractual obligations of non-governmental payers, and are reflective of the services delivered by the department.

The incumbent is also responsible to implement special projects related to new hospitals, departments, services, and information systems. This position will coordinate and collaborate the above actions with, but not limited to, clinical departments, the Central Business Office, Health Information Management, Information Systems, Managed Care, Corporate Finance & Financial Reporting, and Ethics & Compliance.

Responsibilities And Duties:

1. 30%
Chargemaster Development:
Develop and maintain charge description masters for central Ohio operations. Research federal, state, and non-governmental requirements to assign compliant billing codes for each payer. Determine patient prices in accordance with principals of charge master standardization, governmental and non-governmental reimbursement methodologies, and with awareness of uninsured or non-covered patients. Ensure that each charge master is comprehensive for all department services. 2.20%
Implementation and

Education:

Research, comprehend and apply to Ohio Health charge masters all changes resulting from annual and quarterly federal and state regulatory changes, including those from CMS Centers for Medicare and Medicaid Service s and the American Medical Association. Communicate changes to operations leaders and department resource persons. Provide necessary education or serve as resource person for education by leaders to their associates. In addition to the clinical departments, collaborate the above actions with the Central Business Office, Health Information Management, Information Systems, Managed Care, and Financial Reporting as necessary.

3.15%
Consultation:
Serve as resource person to campus leaders for research on new technology, alternate reimbursement methodologies, and non-hospital settings. Usually requires incumbent to conduct primary research about services or settings not currently offered in care sites. Findings frequently used by campus leaders in pro-forma or CARF development for new business or capital purchases. 4.15%
Charge Audits:
Audit medical documentation for accuracy and appropriateness of facility billing based on Medicare/Medicaid guidelines, validating that supporting documentation exists to confirm accurate billing. Completes audits for Legal, Risk Management, Managed Care, and Revenue Cycle. 5.10%
Special projects:
Assist manager and director with special projects which are typically non-routine in nature, and are completed in addition to routine responsibilities 6.10%
Reports potential compliance concerns immediately:
Present all available information to leaders describing the nature, magnitude, and timeframe of the situation. Participate as requested on teams with operations, compliance, and other finance departments to review the concern and implement corrective action if required.

As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties.

The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time

Minimum Qualifications:

Bachelor's Degree (Required)
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