The Ohio State University, Main Campus

Medical Billing and Coding

• Codes outpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Wexner Medical Center and The James Cancer Hospital
• Assign ICD-10-CM codes for diagnoses of all outpatients treated within the OSU Health System
• Review, analyze, and resolve hospital claim edits that prevent claims from being billed or paid.
• Support accurate and timely revenue capture by identifying and correcting claim errors related to coding, medical necessity, registration, and payer-specific requirements.

Outpatient Medical Coder, Level 2

Financial Planning and Analysis

• Implements and supports the philosophy, mission, values, standards, policies, and procedures of The Ohio State University Wexner Medical Center
• Functions within the multidisciplinary team to secure complex pre-authorizations and prevent/appeal clinical denials
• Utilizes clinical knowledge to interpret and apply medical necessity guidelines
• Makes determinations on the appropriate level of care
• Maintains awareness of State and National Health care trends, JCAHO, CMS, and third-party payer Utilization Management guidelines
• Must be able to read, understand and interpret a payer remit, denial/remark codes, and expected reimbursement to determine the cost effectiveness of completing an appeal
• Must be versatile, flexible, and very adaptable to change

Clinical Financial Case Management, RN Specialist 2

Medical writer

• Responsible for concurrent review of inpatient medical records to identify opportunities for improving the quality of medical record documentation
• Confer with the appropriate caregiver on the additional documentation that may be required
• Achieve a complete medical record by the time of patient discharge
• Follow Joint Commission, Medicare and third party payor documentation guidelines
• Provide assistance to the attending physician and other health care providers in the patient care documentation process

Clinical Documentation Improvement Analyst, Level 2

Clinical Research

• Provide assistance in support of clinical research studies of neural aspects of psychosis and related behaviors.
• Work under supervision in psychiatric data assessment.
• Assist with data management, analysis, and interpretation.
• Contribute to manuscript preparation.

Clinical Research Assistant

Compliance

• Assists with regulatory functions in support of clinical research activity.
• Assists in preparation of protocol submissions to Institutional Review Boards (IRBs) and provides updates on submission status
• Assists in preparation of other required regulatory documents
• Distributes approved documents
• Relays information to clinical research staff
• Assists with data entry including collecting, entering and maintaining data and documents in the OnCore electronic database
• Assists with monitoring visits
• Assists with regulatory issues
• Creates and maintains regulatory files

Regulatory Assistant – Clinical Trials Office

• Under the supervision of the Senior Director of Accounting, the Finance Reimbursement Assistant Director plays a strategic and hands-on role in managing the hospital’s third-party reimbursement activities.
• This includes the annual filing of Medicare and Medicaid cost reports for a large academic medical center with over 600 GME/IME FTEs, $23 million in Medicare DSH reimbursement, and a PPS-Exempt Cancer Hospital.
• The Assistant Director provides high-level analytical and regulatory support across all reimbursement functions, including audits, appeals, DSH, 340(b), wage index, and uncompensated care reporting.
• This role requires a deep understanding of healthcare reimbursement methodologies and financial reporting systems, as well as the ability to lead complex projects and collaborate with senior leadership.
• This position directly supervises two manager-level employees, both of whom are responsible for Finance Reimbursement.
• This position reports to the Senior Director of Accounting.

Finance Reimbursement Assistant Director

Administrative Assistant

• Anticipates Director’s professional needs in relationship to their responsibilities
• Performs a variety of complex and confidential administrative support duties on behalf of the Director
• Effectively anticipates support needs and efficiently prioritizes duties
• Provides strategic support to aid in decision making and strategic planning processes
• Oversees communications related to multi-site laboratory projects
• Ensures scientific and operational alignment between EBB Lab and external partners
• Partners with EBB Lab project manager to help communicate ongoing coordination of details across projects and ideas
• Takes, types and transcribes meeting minutes
• Proactively manages Director’s calendar and scheduling of meetings
• Arranges complex and detailed travel plans and itineraries
• Compiles documents for travel-related meetings and processes required forms
• Prepares travel orders using travel system
• Prepares financial requests using Workday
• Schedules, coordinates, and manages materials, handouts, slides, etc. for speaking engagements, conference submissions and one-time meetings
• Provides support for professional societies: national, regional and local
• Maintains a complete and up to date CV for Director
• Assists with the required aspects of faculty promotion for Director through the Appointment, Promotion and Tenure (AP&T) process
• Other duties as assigned

Manager

• Responsible for the overall administration of 4-H Camp Whitewood
• Maintain a positive atmosphere at camp and provide technical assistance in resident camping
• Manage the operation of 4-H Camp Whitewood including full-time staff and seasonal staff
• Conduct operations in accordance with the mission, policies, and goals of 4-H Camp Whitewood Board of Directors
• Serve collaboratively and foster healthy relationships with the nine counties in the Northeastern Ohio 4-H Camps, Inc (4-H Camp Whitewood) Corporation
• Operate and maintain the camp under ACA and OSU standards
• Provide leadership to the process that will result in a positive revenue stream for 4-H Camp Whitewood
• Work cooperatively with the Camp Board of Directors for the development and implementation of long-range plans, risk management, marketing and promotion plans, budget preparation, and evaluation of services
• Responsible for the financial management of the camp including income, disbursements, establishing budgets and fees, investment of funds, implementing control procedures, and assisting with the preparation and presentation of camp financial reports
• Focus on developing strong public relations and maintain positive working relationships with current groups and potential customers

Manager 1

• Responsible for daily operational management of Revenue Cycle Clinical Support staff, primarily involving the oversight of clinical appeals and denial analysis, resolution, and prevention for The Ohio State University Health System.
• Implements and supports the philosophy, mission, values, standards, policies, and procedures of The Ohio State University Wexner Medical Center.
• Functions within multidisciplinary teams.
• Leads staff on analysis and resolution of a variety of administrative and clinically related third-party payer denials and drives denial prevention efforts.
• Provides thorough support for the escalation of inappropriately denied claims to payers and external entities.
• Partners with Managed Care to seek resolution and appropriate reimbursement.
• Conducts quality assurance reviews and continuous process improvement on work done by staff and helps drive increase recoveries while maintaining lower AR.

Clinical Appeals Manager

• Perform timely and accurate coding of all facility outpatient visits and outpatient coding audits for The Ohio State University Wexner Medical Center (OSUWMC)
• Oversee the operations of denials, claim edits, and charge capture for reimbursement purposes
• Serve as a liaison and coordinator for special projects regarding the coding of medical records
• Develop and implement policies and procedures to achieve organizational goals
• Monitor employee training, productivity, quality, and overall employee performance of all Outpatient Medical Record Coding Specialists, Failed Claims Specialists, Charge Capture Specialists, and MIM Student Interns
• Conduct focused and random audits of medical records for both coding as well as compliance Outpatient Code Editor (OCE), National Correct Coding Initiative (NCCI) and Medicare Code Editor (MCE) edits

Associate Director, Outpatient Medical Coding

• Coding medical records and other documents at the conclusion of the patient’s visit
• Coding multiple work types for inpatient and outpatient services
• Selecting appropriate admitting diagnosis, principal and secondary diagnoses, principal procedure and secondary procedures
• Assigning accurate ICD-10 and/or CPT-4 codes
• Sequencing the diagnoses and procedures codes
• Abstracting information including admission source, type, disposition, admitting, attending and procedure attending physicians
• Addressing all edits during the coding and abstracting process for complete and accurate coding and MS-DRG and APR-DRG assignment for hospital reimbursement
• Maintaining productivity and quality standards set for the department

Outpatient Medical Coder 3

• Responsible for coding medical records and other documents at the conclusion of the patients visit
• Requires selection of appropriate admitting diagnosis, principal and secondary diagnoses, principal procedure and secondary procedures
• Assigning accurate ICD-10 and/or CPT-4 codes
• Sequencing the diagnoses and procedures codes
• Abstracting information including admission source, type, disposition, admitting, attending and procedure attending physicians
• Codes are selected in the Computer Assisted Coding/Encoder Software following review of information in the electronic medical record system, IHIS
• Responsible to address all edits during the coding and abstracting process for complete and accurate coding and MS-DRG and APR-DRG assignment for hospital reimbursement
• Maintain productivity and quality standards set for the department

Inpatient Medical Coder 3

• Responsible for coding medical records and other documents at the conclusion of the patient's visit
• Requires selection of appropriate admitting diagnosis, principal and secondary diagnoses, and sequencing diagnoses and procedures
• Codes flow from the Encoder Software to EPIC/IHIS Resolute Billing system
• Responsible for complete and accurate coding and MS-DRG and APR-DRG assignment for hospital reimbursement, research, and planning

Inpatient Medical Coder 2

Business Analyst

• Participate and assist in the management of selected pre- and post-award activities for assigned principal investigators (PIs)
• Work closely with senior level team members in following established procedures
• Identify and report noncompliance with sponsor guidelines, such as effort requirements, allowable expenditures
• Update PI current and pending other support documentation within the timeframe identified using various university systems
• Assist with the completion of annual progress reports
• Participate in pre- and post-grant award activities with training on pre- or post-specialization
• Compile statistical, financial, or accounting data
• Review expenses for compliance using approved budget
• Prepare projects for close-out

Grants & Contracts Management Analyst

Project Manager

• Manage complex research and technical assistance projects from proposal through completion
• Oversee the full project lifecycle across multiple large-scale grants
• Monitor project status and recommend corrective actions
• Lead project team meetings and foster relationships with stakeholders
• Contribute to business development and strategic planning