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Job Description Summary:

Responsible for management and control of standardized charge master and reimbursement function and staff.

Responsibilities And Duties:

15%
Management and control of standardized charge master. Manage level of detail, definition, structure, and conception of codes, includes informing performing departments of newly approved services to maximize opportunities for net revenue. Approve appropriateness of requested changes.  Present complex information in a clear and concise format.

20%
Strategic planning for hospital-wide or specialty/program price changes. Review with hospital/program administrators, Decision Support, Patient Accounting and Billing Compliance. Implement, coordinate changes among core hospital systems and department systems. Perform post change analysis and reporting. Ensure that pricing remains at or above various fee schedules, payment rates, and applicable contracts. Manage prices to hospital policy, modifying policy and obtaining approval when necessary. 

Managing projects and processes in the annual completion of the system Strategic Financial Plan (Long range financial plan and Budget), Medicare and Medicaid cost reports, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned.  Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement is necessary. Expected to be a subject matter expert in these areas, remaining up to date with all regulatory requirements, both federal and state is required.
 
20%
Education and process improvement of charge processing procedures in the hospital directed to ensure accurate and timely capture of hospital charges. Requires ability to understand department operations, and system s functionality, and gain acceptance from hospital departments regarding charge-processing procedure that best supports both. Perform both scheduled and ad-hoc education. 

Manages, leads, advises, and consults various reimbursement financial projects, as well as special projects throughout the year.  Needs to be able to delegate and direct reports assigned to the project or process while staying connected to both the pertinent details as well as the high-level strategic purpose.
 
10%
Link between clinical and financial areas of hospital, ensuring communication to financial areas regarding new department setup, new services, etc. Communicate charge master changes to support procedure costing, financial analysis, and financial reporting.  Functions in a heavily matrixed environment and requires strong prioritization, communication, and planning skills.

15%
Ensure department remains current on billing regulations and governmental rulings/announcements. Ensure that needed changes are researched and made in charge master, understood by performing departments and communicated to those managing core and other systems.

​20%
Management of department staff and functions including hiring, education, goal planning, reviews, performance recognition and improvement, and terminations. Ensure staff and department comply with organizational policies and procedures.  Department secession planning on knowledge transfer of all positions in the department must be applied and managed.

Minimum Qualifications:

Bachelor's Degree (Required)

Additional Job Description:

Manager Charge Analysis & Reimbursement

JOB SUMMARY

Responsible for management and control of standardized charge master and reimbursement function and staff.

MINIMUM QUALIFICATIONS

Field of Study: Finance
Field of Study: Science
Field of Study: Allied Medicine
Field of Study: Hospital Administration
Years of experience: 5 to 8

SPECIALIZED KNOWLEDGE

• Field of Study: Finance, science, or Allied Med. Hospital Administration, Master's science, MBA, etc. statistics; critical evaluation skills. sQL or application development in MS Access.
• Knowledge of hospital operations, patient processing (registration through collection). 5 8 years in hospital healthcare setting, including management Experience or staff
• Experience managing a function.
• Knowledge years related Experience in healthcare.
• Experience relevant from clinical department business office medical records or finance.

DESIRED ATTRIBUTES

• Master's Degree in Hospital Administration, Master's science, MBA,

RESPONSIBILITIES AND DUTIES

15%
Management and control of standardized charge master. Manage level of detail, definition, structure, and conception of codes, includes informing performing departments of newly approved services to maximize opportunities for net revenue. Approve appropriateness of requested changes.  Present complex information in a clear and concise format.

20%
Strategic planning for hospital-wide or specialty/program price changes. Review with hospital/program administrators, Decision Support, Patient Accounting and Billing Compliance. Implement, coordinate changes among core hospital systems and department systems. Perform post change analysis and reporting. Ensure that pricing remains at or above various fee schedules, payment rates, and applicable contracts. Manage prices to hospital policy, modifying policy and obtaining approval when necessary. 

Managing projects and processes in the annual completion of the system Strategic Financial Plan (Long range financial plan and Budget), Medicare and Medicaid cost reports, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned.  Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement is necessary. Expected to be a subject matter expert in these areas, remaining up to date with all regulatory requirements, both federal and state is required.
 

20%
Education and process improvement of charge processing procedures in the hospital directed to ensure accurate and timely capture of hospital charges. Requires ability to understand department operations, and system s functionality, and gain acceptance from hospital departments regarding charge-processing procedure that best supports both. Perform both scheduled and ad-hoc education. 

Manages, leads, advises, and consults various reimbursement financial projects, as well as special projects throughout the year.  Needs to be able to delegate and direct reports assigned to the project or process while staying connected to both the pertinent details as well as the high-level strategic purpose.
 

10%
Link between clinical and financial areas of hospital, ensuring communication to financial areas regarding new department setup, new services, etc. Communicate charge master changes to support procedure costing, financial analysis, and financial reporting.  Functions in a heavily matrixed environment and requires strong prioritization, communication, and planning skills.

15%
Ensure department remains current on billing regulations and governmental rulings/announcements. Ensure that needed changes are researched and made in charge master, understood by performing departments and communicated to those managing core and other systems.

​20%

Management of department staff and functions including hiring, education, goal planning, reviews, performance recognition and improvement, and terminations. Ensure staff and department comply with organizational policies and procedures.  Department secession planning on knowledge transfer of all positions in the department must be applied and managed.

Work Shift:

Day

Scheduled Weekly Hours :

40

Department

Charge Analysis

Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry

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 person 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