Financial Clearance Rep I

Ali Aydi; Cincinnati (OH); Hybrid; USD 40.000 - 60.000; Vollzeit

Zusammenfassung

Cincinnati Children's is seeking a role focused on securing pre-authorization for services and medications, validating insurance details, and maintaining billing workflows. The team collaborates with hospital departments to ensure smooth admissions and outpatient processes.

The position emphasizes independent work and adherence to productivity standards, with attention to accurate data entry, insurance verification, and escalation when issues arise. Equal opportunity employer.

Qualifikationen

• High school diploma or equivalent.
• No directly related experience.

Aufgaben

• Pre-Authorization- Efficiently obtain pre-authorizations for scheduled services and medications using medical records and systems.
• Productivity- Work independently and/or collaboratively with team to efficiently handle work volume and queues to meet or exceed productivity standards.
• Collaboration- Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review and other Cincinnati Children's departments.
• Problem Resolution- Initiate calls to appropriate parties both internal and external to resolve issues.

Ausbildung

High school diploma or equivalent

Jobbeschreibung

*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.

JOB RESPONSIBILITIES

• Pre-Authorization- Efficiently obtain pre-authorizations for scheduled services and medications using medical records and systems. Collaborate with internal and external resources on authorization scenarios. Contact families before scheduled visits to confirm insurance eligibility and referrals with minimal stress. Collect/provide insurance-based estimates and adhere to registration workflows. Maintain a general understanding of billing processes.


• Productivity- Work independently and/or collaboratively with team to efficiently handle work volume and queues to meet or exceed productivity standards. Accurately collect/verify insurance information and demographics, obtaining insurance authorization and entering the information into the required systems.


• Collaboration- Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review and other Cincinnati Children's departments. Multiple division support; cross trained in order to work insurance pre-authorization for multiple divisions.


• Problem Resolution- Initiate calls to appropriate parties both internal and external to resolve issues. Escalate to appropriate staff regarding system errors, recurring divisional problems/errors identified within work queues or reports.

JOB QUALIFICATIONS

• High school diploma or equivalent


• No directly related experience

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 a top 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's America's Most Innovative Companies as noted by Fortune


• Consistently certified as great place to work


• A Leading Disability Employer as noted by the National Organization on Disability


• Magnet designated for the fourth consecutive time by the American 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

Tags

Management and Finance Problem Resolution Customer Service and Data Entry

Details

Who may apply USA Only As the board states it - check the description for country or time-zone limits.