OhioHealth

• Provides exceptional customer service during every encounter with patients, families, visitors and OhioHealth physicians and associates • Accept inbound calls within a specific response-to-call timeframe following customer service standards at all time • Makes outbound calls with according to the standard work and following customer service standards • Accurately identifies patient in the EMR system • Adhere to the department Standard Work • Obtains and enters accurate patient demographic and financial information while maintaining patient confidentiality • Uses critical thinking skills to make decisions, resolve issues, or escalate concerns • Verifies insurance eligibility using online eligibility system, payer websites or by phone call • Processes faxes and transcribes information into the system’s EMR • Follow protocols for directly contacting the care centers regarding urgent patient requests and ensure timely follow up • Schedules outpatients appointments • Generates, prints, and provides patient estimates utilizing price estimator products • Inform patient of any outstanding balance, collect balance and co-payment or provide financial assistance information • Answers questions or concerns regarding insurance residuals and self-pay accounts • Uses knowledge of CPT codes to accurately select codes from clinical descriptions • Identifies and/or determines patient Out of Network acceptance into the organization • Explains billing procedures, hospital policies and provides appropriate literature and documentation • Update/notate all accounts using appropriate standard work • Reviews insurance information and determines need for referrals and/or financial counseling • Educates patients on MyChart, including activation • Participate in and contribute to development of Lean processes • Complies with all organizational, state and federal laws and regulations related to patient privacy and confidentiality (ie. PHI, HIPAA, etc.) • Work collectively in a professional manner • Confirms physician's orders/visit purpose • Verifies multidisciplinary patient schedules for Outpatient visits to expedite patient processing • Obtains Release of Information authorization from patients to release medical records • Uses conflict resolution skills and service recovery to handle customer service concerns • Resolve patient complaints and concerns and, if unable to resolve, escalate appropriately • Provides information to physician offices and other hospital departments when needed

Role Description The Nurse Scientist is a PhD prepared nursing professional responsible for advancing nursing science, evidence-based practice (EBP), and scholarly quality improvement (QI) across the organization. This role integrates research, EBP, and implementation science and facilitation to improve patient outcomes, strengthen nursing practice, and support organizational priorities. The Nurse Scientist collaborates with clinical nurses, leaders, and interprofessional teams to design, conduct, and translate research into practice while fostering a culture of inquiry and professional development. Responsibilities And Duties - Research & Scientific Leadership: - Design, lead, and manage multiple concurrent research studies across clinical settings - Apply expertise in quantitative, qualitative, and mixed methods research designs - Secure, manage, and complete funded research projects (internal and external) - Ensure regulatory compliance including IRB processes, HIPAA, and protection of PHI - Disseminate findings through peer-reviewed publications, presentations, and internal forums - Evidence-Based Practice (EBP) & Quality Improvement: - Lead and mentor EBP and Scholarly Quality initiatives using established frameworks - Guide translation of evidence into practice in partnership with clinical and operational leaders - Support development and evaluation of clinical practice changes using robust outcome metrics - Apply QI methodologies to improve care delivery, safety, and patient outcomes - Education, Mentorship & Capacity Building: - Mentor nurses and interprofessional team members across all levels (entry-level through doctoral) - Develop and deliver educational programming to build EBP and research competency - Foster a spirit of inquiry and motivate clinical nurses to engage in research and EBP activities - Consultation & Organizational Support: - Serve as a consultant to senior leaders for evidence acquisition, synthesis, and application - Partner with nursing leadership to evaluate practice gaps and identify evidence-informed solutions - Provide expertise in evaluation design, measurement strategies, and analytic approaches - Consult with clinical nurses at all levels to improve clinical practice and advance professional development goals. - Professional & Interpersonal Leadership: - Demonstrate strong customer service orientation - Communicate effectively with nurses and stakeholders at all levels - Work independently while managing competing priorities - Promote ethical decision-making and professional accountability - Information Security: - Maintains confidentiality of log-on password(s) and security of other authentication devices (e.g., key fobs, proximity devices, etc.) - Ensures privacy and security of information entrusted to their care - Uses company business assets and information resources for management-approved purposes only - Adheres to all information privacy and security policies, procedures, standards, and guidelines - Promptly reports information security incidents to the OhioHealth Information Security Officer Qualifications - Doctorate: Nursing (Required) Requirements - Scientific rigor and methodological expertise - Strategic thinking and systems-level perspective - Advanced communication and stakeholder engagement - Project and portfolio management - Teaching, coaching, and mentorship excellence - Ethical judgment and knowledge of regulatory compliance - Ability to translate evidence into actionable practice Work Shift - Day Scheduled Weekly Hours - 40 Department - Nursing Excellence 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. Remote Work Disclaimer Positions marked as remote are only eligible for work from Ohio.

• Responsible for overseeing all functions related to billing department. • Obtaining Prior Authorizations for all medications. • Resolution of denied claims. • Electronic claims submission and other billing duties as assigned. • Coordination of drug procurement. • Scheduling all patients and coordination of care with ordering physician offices. • Ensuring quality standards are met and all reporting functions are accurate and submitted in a timely manner. • Responsible for revenue cycle processes including prior authorizations, insurance claims submission and follow-up in accordance with established policies and procedures, benefit verification, patient enrollment with various Risk Evaluation and Mitigation Strategy programs and financial assistance programs. • Patient appointment scheduling including patient lodging and transportation set up. • Work collaboratively with hospital personnel management team to address processes that affect revenue cycle.

Role Description The Patient Service Representative I role may be the initial point of contact for patients, physicians, and the public at large. This position provides exceptional public relations/customer service during encounters with patients, families, visitors, and Ohio Health physicians and associates. The primary responsibilities are: - Scheduling/registration - Patient billing follow-up - Identify and execute a plan meeting the needs of the caller Responsibilities And Duties The Patient Service Representative I may be expected to perform any of the following and other duties as assigned: - Provides exceptional customer service during every encounter with patients, families, visitors, and OhioHealth physicians and associates - Accept inbound calls within a specific response-to-call timeframe following customer service standards at all times - Makes outbound calls according to the standard work and following customer service standards - Accurately identifies patient in the EMR system - Adhere to the department Standard Work - Obtains and enters accurate patient demographic and financial information while maintaining patient confidentiality - Uses critical thinking skills to make decisions, resolve issues, or escalate concerns - Verifies insurance eligibility using online eligibility system, payer websites, or by phone call - Processes faxes and transcribes information into the system’s EMR - Follow protocols for directly contacting the care centers regarding urgent patient requests and ensure timely follow-up - Schedules outpatient appointments - Generates, prints, and provides patient estimates utilizing price estimator products - Informs patient of any outstanding balance, collects balance and co-payment, or provides financial assistance information - Answers questions or concerns regarding insurance residuals and self-pay accounts - Uses knowledge of CPT codes to accurately select codes from clinical descriptions - Identifies and/or determines patient Out of Network acceptance into the organization - Explains billing procedures, hospital policies, and provides appropriate literature and documentation - Updates/notates all accounts using appropriate standard work - Reviews insurance information and determines need for referrals and/or financial counseling - Educates patients on MyChart, including activation - Adhere to policy and procedures - Participate in and contribute to development of Lean processes - Complies with all organizational, state, and federal laws and regulations related to patient privacy and confidentiality (e.g., PHI, HIPAA, etc.) - Works collectively in a professional manner - Confirms physician's orders/visit purpose - Verifies multidisciplinary patient schedules for Outpatient visits to expedite patient processing - Obtains Release of Information authorization from patients to release medical records - Uses conflict resolution skills and service recovery to handle customer service concerns - Resolves patient complaints and concerns and, if unable to resolve, escalates appropriately - Provides information to physician offices and other hospital departments when needed Qualifications - High School or GED (Required) - Typing of 40 wpm - Excellent communication, organization, and basic computer skills - 1-2 years of previous experience in the service industry with a focus on delivering exceptional customer service, or - 1-2 years previous experience in a Medical Office setting, or - 1-2 years previous experience in a Call Center, or - 1-2 years previous experience in Collections Work Shift - Day Scheduled Weekly Hours - 40 Department - Patient Contact Center 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. Remote Work Disclaimer Positions marked as remote are only eligible for work from Ohio.

• Managing multiple medium to large size system-wide projects involving a variety of information technology platforms • Leading project teams through planning, executing, and controlling activities to meet customer requirements • Monitoring compliance with project management standards • Providing leadership in Information Services or respective departments • Serving as a mentor to new or less experienced project managers

• Receive inbound and makes outbound calls to patients/guarantors on account balances • Advise of remaining account balance(s) and answer any questions • Identify concerns/objections and determine best course of action • Negotiate for payment in full or maximum payment arrangements according to policy • Screen patient/guarantors for insurance, billing or financial aid opportunities • Respond to patients/guarantors requests and thank them for using OhioHealth services • Update patient demographic data and establish rapport with patients/guarantors • Accurately document account, make adjustments or referrals as appropriate • Make recommendation for manual charge off based on defined criteria • Maintain quality and productivity requirements

Role Description This position assists the HIM/OPG Coding Manager to supervise, monitor, evaluate and train coders in ICD-10/PCS, CPT and HCPCS Level II coding guidelines, modifier guidelines, proper diagnosis and procedure and code selection, documentation guidelines and abstracting for reimbursement, insurance purposes and statistical reports. Understands APR/RVU guidelines. - Directly supervises 12-20 FTE's across the system in Coding/Abstraction. - Regularly monitors productivity and performance of all functions within the team to keep within quality and quantity goal ranges. - Reports problems and achievements to manager in a timely manner. - Performs data quality reviews on professional, outpatient and inpatient encounters to validate coding assignments and ensure compliance with coding guidelines. - Monitors outpatient reports and identifies shifts and trends in facility's most frequently assigned diagnoses/procedures. - Evaluates quality of documentation to identify incomplete or inconsistent documentation impacting codes and assignments. - Provides training to health care professionals in coding guidelines and practices. - Collects and prepares data for specialized studies and reports. - Attends coding and reimbursement workshops and maintains current information and technologies. - Shows competency in computer applications and use of APC/RVU and DRG Grouping Software. - Performs random UB-04/HCFA 1500 reviews to ensure proper code transfer. - Monitors and responds to Peer Review Organization or Medicare Integrity Program contractor changes and denial letters. - Provides education to hospital staff on changes to payment systems and code updates. - Communicates updates published in Medicare FI newsletter, bulletins, and provider manuals. - Monitors unbilled accounts reports for outstanding and un-coded outpatient encounters. - Performs other duties as assigned. Qualifications - Associate's Degree (Required) - Bachelor's or Associate's degree in health information or related field. - Excellent communication skills, leadership, interpersonal and organizational skills OR 3 - 5 years coding experience. Requirements - Work Shift: Day - Scheduled Weekly Hours: 40 - Department: Physician Coding Benefits - Join us if your passion is to work in a caring environment. - Join us if you believe that learning is a life-long process. - Join us if you strive for excellence and want to be among the best in the healthcare industry. Company Description 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. Positions marked as remote are only eligible for work from Ohio.

Role Description This position assists in development, implementation, and revision of the utilization management program. Monitors adherence to the hospital's utilization review plan to ensure effective and efficient use of hospital services and reviews the appropriateness of hospital admissions and extended hospitals stays. Performs utilization review in accordance with all state and federal mandated regulations. Maintains compliancy with regulation changes affecting utilization management. - Reviews all patients' medical records and assigns status following Interqual/mcg guidelines. - Obtains and reviews necessary physician orders, medical reports, and subsequent treatment plans to conduct review. - Monitors observation status and outpatient occupying a bed for medical necessity criteria. - Communicates with members of the healthcare team to ensure timely orders for appropriate changes in level of care. - Refers to designated Physician Advisor those patients not meeting severity of illness and intensity of service for acute care. - Performs concurrent review on medical records and participates in interdisciplinary collaboration with professional staff. - Communicates with third party payers and sends appropriate clinical information for authorization of hospital stay. - Receives and processes requests for appeal of denials. - Ensures appropriate and cost-effective healthcare services to patients. Actively participates in development, implementation, and ongoing evaluation of the utilization management program. - Facilitates and/or develops educational programs and advises physicians and other departments of regulations affecting utilization management, efficient allocation of resources, and appropriate length of stay. - Monitors quality and type of services delivered to patients, ensuring management within established parameters. - Actively participates in program development and quality improvement process to ensure quality outcomes. - Acts as preceptors to new hires. As a High Reliability Organization (HRO), responsibilities require focus on safety, quality, and efficiency in performing job duties. The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time. Qualifications - Bachelor's Degree (Required) - BLS - Basic Life Support - American Heart Association - CPI - Crisis Prevention Intervention - Crisis Prevention Intervention - Graduate from an accredited Bachelor's of Nursing Program - Current State of Ohio RN licensure - Familiarity with computer technology, and ability to use database and spreadsheets - Excellent written/verbal communication and teaching/training skills - Demonstrated success in achieving or exceeding measurable performance criteria in a job setting - Three or more years of clinical experience within hospital or payer setting - Case Management Certification within first year - BSN or 15 years of nursing experience at OhioHealth Requirements - Must have Basic Life Support (BLS) and Crisis Prevention Intervention (CPI) obtained within the first 30 days of hire and must remain current if in the Behavioral Health Department. Benefits - Join us if your passion is to work in a caring environment. - Join us if you believe that learning is a life-long process. - Join us if you strive for excellence and want to be among the best in the healthcare industry. Company Description 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. Positions marked as remote are only eligible for work from Ohio.

• Coordinates small projects for the IS department following the IS PMO methodology • Tracks and monitors project tasks assigned to the project team • Acts as a single point of contact for assigned projects • Responsible for regular project reporting activities, project communications and supporting documentation • Works collaboratively with assigned IS resources to ensure project tasks are getting completed with effective communication throughout the life cycle of the project • Supports PMO project portfolio analysis and maintenance • Responsible for creating and distributing PMO portfolio reports.

• The CVO PM manages and coordinates the credentialing and recredentialing process for all applicants to the OhioHealth Medical Staff, Allied Practitioner Staff, the CIN, and/or the OhioHealthy Medical Plan. • The CVO PM will utilize three sets of credentialing policies and procedures managed by the CVO to support TJC accreditation for the OhioHealth hospitals and NCQA accreditation to support the CIN and OhioHealthy Medical Plan. • The CVO PM is accountable for ensuring all information is accurate and up to date prior to completing an application. • The CVO PM will collaborate with applicants and/or credentialing contacts to resolve discrepancies in application documents. • The CVO PM will collaborate with associates of other OhioHealth medical affairs teams, the CIN and/or OhioHealthy to address questions related to a providers credentialing application or status in the credentialing process. • The CVO PM will complete the credentialing assignment and ensure compliance with regulatory guidelines, including all applicable policies and procedures that govern the credentialing department. • The CVO PM will appropriately identify applications that require medical director review by following credentialing department policies specific to the CIN and OhioHealthy. • The CVO PM will prepare the Medical Director Review (MDR) packet and collaborate with CVO leadership when a review is needed. • The CVO PM will maintain confidentiality for all credentialing/re-credentialing/membership issues. • The CVO PM will participate in system-wide credentialing initiatives as identified (ex: process improvement projects). • The CVO PM will participate in KPI (key performance indicator) huddles as scheduled. • The CVO PM will participate in weekly gemba meetings including development of information to share along with presentation of topic as required by department gemba schedule. • The CVO PM will work individually and independently with minor supervision while meeting productivity expectations and maintaining high quality work.