Pharmacy Svcs 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 will combine working knowledge of charge capture and billing processes as well as familiarity with upstream data architecture, clinical workflows and downstream billing edits to ensure revenue integrity; performs wide range of assignments and special projects spanning the charge initiation to reimbursement spectrum; routinely collaborates with stakeholders beyond job discipline (e. g. IS, Finance, Nursing, Managed Care); supports onboarding of new associates and serves as a resource for pharmacy experiential training rotations (students and residents); impacts financial performance across the service line; distills complex technical information and root causes into easily understandable business summaries for diverse audiences.

RESPONSIBILITIES AND DUTIES
1. Chargemaster Development/Maintenance: Develop and maintain charge description masters across OhioHealth care-sites. Research federal, state and non-governmental requirements to assign compliant billing codes for each payer. Ensure the chargemaster is comprehensive for all pharmaceutical services.
2. Implementation and Education: Research, comprehend and apply to the chargemasters all changes resulting from annual and quarterly federal and state regulatory changes. Collaborate with clinical departments, Revenue Cycle, Health Information Management, Information Systems, Managed Care, Corporate Finance & Financial Reporting and Ethics & Compliance.
3. Consultation: Serve as a resource person to campus leaders for research on new technology, alternate reimbursement methodologies and non-hospital settings.
4. Charge Audits: Conduct audits for accuracy and appropriateness of facility billing based on Medicare/Medicaid guidelines, validating that supporting documentation exists to confirm accurate billing.
5. 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. Compliance Reporting: Report and present all potential compliance concerns to leaders and participate as requested on teams for corrective action if required.

Minimum Qualifications:

High School or GED (Required)CCS - Certified Coding Specialist - American Health Information Management AssociationAmerican Health Information Management AssociationAmerican Health Information Management AssociationAmerican Health Information Management Association, CCSP - Cisco Certified Security Professional - CISCO - Computer Information System CompanyCISCO - Computer Information System CompanyCISCO - Computer Information System CompanyCISCO - Computer Information System Company, CPC - CPC Certified Professional Coder - AAPC American Academy of Professional CodersAAPC American Academy of Professional CodersAAPC American Academy of Professional CodersAAPC American Aca