BMT Financial Clearance Rep III

Cincinnati Children's; Cincinnati (OH); Hybrid; USD 46,000 - 58,000; Full time

Job summary

Cincinnati Children’s is seeking a BMT Financial Clearance Rep III to coordinate financial clearance, pre-authorizations, and payer requirements across the patient journey. You will work with care teams, insurers, and revenue cycle colleagues to move high-value cases efficiently.

Day shift with hybrid in-office Tuesdays, using Epic and payer portals. Strong organization and communication are essential to succeed in this role.

Qualifications

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

Responsibilities

• Obtain pre-authorizations for complex services and medications using medical records, Epic, and payer portals.
• Manage daily appointment and authorization work queues while tracking dates, submissions, payer requirements, and follow-ups.
• Coordinate with care managers, providers, insurers, billing teams, and other partners to resolve authorization and coverage issues.
• Communicate authorization status and next steps primarily by email, with phone outreach to insurers and some patient/family contact.
• Collect and verify insurance and demographic information, document in required systems, and maintain billing knowledge.
• Serve as a resource for complex authorization questions and share improvement opportunities with leadership.
• Cross-train across department and division authorization processes and support team workload as needed.

Skills

Strong organization

Clear professional communication

Payer requirements interpretation

Decision making under pressure

Collaboration

Education

High school diploma or equivalent

Tools

Epic

Job description

• Expected Starting Pay Range $22.18 - $27.73
• Starting pay is based on experience, skills, and equity; exceptions may apply for highly qualified candidates. Additional pay (e.g., shift, on-call, or weekend differentials) and benefits may apply. Annual pay may vary based on FTE status.

Primary Location

South Campus

Department

Financial Clearance Center

Shift

Day (United States of America)

Schedule

Full time

Weekly Hours

40

FTE

1

Employee Status

Regular

• Expected Starting Pay Range $22.18 - $27.73
• Starting pay is based on experience, skills, and equity; exceptions may apply for highly qualified candidates. Additional pay (e.g., shift, on-call, or weekend differentials) and benefits may apply. Annual pay may vary based on FTE status.

BMT Financial Clearance Rep III

Help support access to highly complex bone marrow transplant care by coordinating financial clearance, prior authorizations, and payer requirements across the full patient journey. In this role, you will partner closely with care teams, providers, insurers, and revenue cycle colleagues to keep high-value, time-sensitive cases moving accurately and clearly.

What You Will Do

• Obtain pre-authorizations for complex scheduled services, medications, HLA typing, bone marrow transplant services, and related care using medical records, Epic, and payer portals.
• Manage daily appointment and authorization work queues while tracking dates, clinical submissions, payer requirements, and follow-up actions.
• Coordinate with care managers, providers, insurers, billing teams, and other internal partners to resolve authorization, eligibility, referral, contract, and coverage issues.
• Communicate authorization status and next steps primarily by email, with phone outreach to insurers and occasional support for patients and families when escalation is needed.
• Collect and verify insurance and demographic information, document accurately in required systems, and maintain a working understanding of billing processes.
• Serve as a resource for complex authorization questions, identify recurring payer issues, and share improvement opportunities with leadership.
• Cross-train across department and division authorization processes and support team workload as needed.

What Will Help You Be Successful

• Strong organization and follow-through across long-running cases with multiple dates and dependencies.
• Clear, professional communication with clinical teams, providers, insurers, internal partners, patients, and families.
• Comfort interpreting payer requirements, submitting clinical information, and using authorization portals.
• Sound judgment when working through complex or conflicting information and escalating when appropriate.
• Ability to balance independent work, productivity expectations, accuracy, and collaboration.

Job Qualifications

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

Preferred Qualifications

• Minimum of 1 year of experience with insurance authorizations.
• Experience in insurance billing, revenue cycle, financial clearance, or customer service involving payer questions.
• Experience supporting complex medication, oncology, hematology, transplant, or other clinically detailed authorizations.
• Familiarity with Epic and payer authorization portals.
• Clinical exposure is helpful but is not required.

Work Environment

This team follows a hybrid work model with an in-office day on Tuesdays. The role uses Epic, email, phone communication, and payer portals. The interview process is expected to be virtual.

About Us

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

• Recognized by U.S. News & World Report as atop 10 best Children's Hospitals in the nation for more than 15 years
• Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH)Funding
• Recognized as one of America’s Best Large Employers (2025), America’s Best Employers for New Grads (2025)
• One of the nation'sAmerica’s Most Innovative Companiesas noted by Fortune
• Consistently certified as great place to work
• A Leading Disability Employeras noted by theNational Organization on Disability
• Magnet® designated for the fourth consecutive time by theAmerican Nurses Credentialing Center (ANCC)

• We Embrace Innovation—Together. We believe in empowering our teams with the tools that help us work smarter and care better. That’s why we support the responsible use of artificial intelligence. By encouraging innovation, we’re creating space for new ideas, better outcomes, and a stronger future—for all of us.

Comprehensive Job Description Provided Upon Request.

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