Professional Billing Finance Rep II

JOB RESPONSIBILITIES

• Own the Professional Billing Lifecycle
• Prepare, review, and submit accurate professional claims using Epic and payer-specific tools.
• Scrub claims to ensure correct codes, units, modifiers, authorizations, and documentation are present before submission.
• Review and resolve edits, rejections, and payer error responses including coding inconsistencies or missing information.
• Lead Payer Follow-Up & Claims Resolution
• Conduct timely follow-up with insurance carriers to resolve outstanding claims.
• Investigate denials (technical and clinical), coordinate corrections, and resubmit claims as needed.
• Identify trends in payer behavior to reduce preventable denials and accelerate reimbursement cycles.
• Deliver High-Quality Financial Accuracy
• Process, post, and balance payments, adjustments, and payer responses with precision.
• Monitor accounts receivable and escalate complex claim issues using established workflows.
• Support charge review and address discrepancies proactively to avoid downstream billing issues.
• Strengthen Billing Operations & Systems
• Maintain and update provider, payer, and billing templates in departmental systems.
• Assist with charge master maintenance to ensure accuracy and competitiveness.
• Support system updates and workflow enhancements that improve billing efficiency.
• Collaborate Across the Organization
• Partner closely with clinic teams, coding, Physician Billing Services, Admitting, Financial Services, Payer Relations, and others to ensure complete and compliant claims.
• Provide guidance to peers and act as a resource for non-routine billing functions.
• Support onboarding of new team members as a preceptor or subject matter resource when needed.

Why This Role Matters

Professional billing is complex — but the stakes are high. Your attention to detail helps:

• Secure reimbursement that sustains Cincinnati Children’s world‑leading care
• Ensure providers are paid accurately for their work
• Reduce stress and uncertainty for families
• Enhance compliance and avoid preventable revenue loss

Your expertise contributes to a revenue cycle that operates with integrity, efficiency, and compassion.

• High school diploma or equivalent
• 2+ years of work experience in a related job discipline

• Primary Location
  :
  South Campus
• Schedule
  :
  Full time
• Shift
  :
  Day (United States of America)
• Department
  :
  Professional Billing Operation
• Employee Status
  :
  Regular
• FTE
  : 1
• Weekly Hours
  : 40
• 
  * Expected Starting Pay Range
• Annualized pay may vary based on FTE status: $18.16 - $22.25

At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s.

Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability