Billing Follow-Up & Denials Specialist II

Cincinnati Children's Hospital Medical Center; Cincinnati (OH); On-site; USD 25,000 - 31,000; Full time

Job summary

Cincinnati Children's Hospital Medical Center is seeking a Professional Billing Representative for the South Campus. The role supports revenue cycle through timely billing, claim resolution, payment posting, and follow-up with payers and patients.

Responsibilities include reviewing claims, following up on denials, and ensuring documentation for resolution while meeting productivity and quality goals. A background in healthcare billing and EHR proficiency are required.

Qualifications

• High school diploma or equivalent.
• 2+ years of healthcare billing or related experience.
• Basic understanding of medical terminology, insurance plans, and billing workflows.
• Experience using EHR and/or billing systems.

Responsibilities

• Review and process professional claims for accuracy and completeness.
• Follow up on outstanding insurance claims and unpaid balances.
• Research and resolve claim denials, rejections, and payment discrepancies.
• Communicate with insurance carriers regarding claim status and reimbursement issues.
• Work with clinical and operational teams to obtain documentation for claim resolution.
• Maintain accurate account documentation within billing and practice management systems.
• Process adjustments, corrections, and rebilling activities as appropriate.
• Assist patients with billing questions and account inquiries.
• Meet productivity, quality, and account resolution goals.
• Maintain knowledge of payer guidelines, billing regulations, and revenue cycle best practices.

Skills

Attention to detail

Multitasking

Problem solving

Communication

Customer service

Independent work

Education

Associate's degree in Business or Healthcare Administration

Tools

EHR systems

Epic

Billing systems

Job description

Cincinnati Children's Hospital Medical Center is seeking a Professional Billing Representative for the South Campus. The role supports revenue cycle through timely billing, claim resolution, payment posting, and follow-up with payers and patients.

Responsibilities include reviewing claims, following up on denials, and ensuring documentation for resolution while meeting productivity and quality goals. A background in healthcare billing and EHR proficiency are required.