Charge Analyst

OhioHealth; Columbus (OH); On-site; USD 90,000 - 120,000; Full time

Job summary

OhioHealth is seeking a Chargemaster Manager to oversee development and maintenance of charge description masters across 1000+ departments, ensuring compliant billing for all payer types and hospital services.

The role involves applying federal/state regulatory changes, educating operations, and coordinating with Central Business Office, Health Information Management, IT, Managed Care and Finance. Day shifts, 40 hours per week, in Columbus, OH.

Qualifications

• Bachelor's Degree required for the role.
• Certifications CPC, CPC-H, RHIA or RN licensure are required or desirable.
• 3-5 years experience in Patient Accounts, Health Information Management or Charge Description Master Management likely expected.

Responsibilities

• Chargemaster development and maintenance for central Ohio operations; ensure compliant billing codes and comprehensive chargemaster coverage for all department services.
• Implement and educate on regulatory changes from CMS and other agencies; communicate changes to operations leaders and departments.
• Serve as campus resource for new technology, alternative reimbursement methods and capital project justification.
• Audit medical documentation for accuracy of facility billing per Medicare/Medicaid guidelines and complete audits for Legal, Risk, Managed Care and Revenue Cycle.
• Assist manager and director with non-routine special projects and initiatives.
• Report potential compliance concerns promptly to leadership and participate in cross-finance teams to address issues.

Education

Bachelor's Degree (Required)

CPC — Certified Professional Coder (AAPC)

CPCH — Certified Professional Coder - Hospital (AAPC)

RHIA — Registered Health Information Administrator (AHIMA)

RN — Registered Nurse (Ohio Board of Nursing)

Tools

Excel

Access

Epic

Job description

Job Description Summary

This position is responsible for the proactive management of the charge masters and fee schedules for OhioHealth 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

• 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 principles 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.
• 20% 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.
• 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.
• 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.
• 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.
• 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.

Minimum Qualifications

• Bachelor's Degree (Required)
• Certification: CPC — Certified Professional Coder (AAPC), CPCH — Certified Professional Coder - Hospital (AAPC), RHIA — Registered Health Information Administrator (AHIMA), RN — Registered Nurse (Ohio Board of Nursing)

Additional Job Description

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.

Work Shift

Day

Scheduled Weekly Hours

40

Department

Charge Analysis

Equal Employment Opportunity

OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all persons in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment.