Charge Analyst

Responsibilities

• 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 chargemaster standardization, governmental and non-governmental reimbursement methodologies, and with awareness of uninsured or non-covered patients. Ensure that each chargemaster is comprehensive for all department services.
• Implementation and Education: Research, comprehend and apply to OhioHealth chargemasters all changes resulting from annual and quarterly federal and state regulatory changes, including those from CMS Centers for Medicare and Medicaid Services 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.
• 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.
• 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.
• Special projects: Assist manager and director with special projects which are typically non-routine in nature, and are completed in addition to routine responsibilities.
• 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.

Qualifications

• Bachelor's Degree (Required)
• Certification in at least one of the following: RN, CPC, CPC-H, CCS, CCS-P, RHIA, or Bachelor’s degree in Health Information Management or related field.
• Knowledge of clinical and financial applications for documentation, billing, coding and patient accounting.
• 3 - 5 years Experience in Patient Accounts, Health Information Management or Charge Description Master Management.
• Proficiency in Excel, Access, Reporting and Epic.