Financial Clearance Representative I - Hybrid

Cincinnati Children's Hospital Medical Center; United States; Vor Ort; USD 26.000 - 32.000; Vollzeit

Zusammenfassung

Cincinnati Children's South Campus is seeking a Pre-Authorization specialist to obtain approvals for scheduled services and medications using medical records and systems. You will verify insurance eligibility, coordinate referrals, and provide insurance estimates while adhering to registration workflows.

The role collaborates with Hospital Billing, Admitting, and Patient Financial Services to resolve issues, maintain accurate demographics, and support productivity standards in a fast-paced

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.
• Collaborate with internal and external resources on authorization scenarios.
• Contact families before scheduled visits to confirm insurance eligibility and referrals.
• Collect/provide insurance-based estimates and adhere to registration workflows.
• Maintain a general understanding of billing processes.
• Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services and other Cincinnati Children’s departments.
• Cross trained to work insurance pre-authorization for multiple divisions.
• Initiate calls to resolve issues and escalate system errors as needed.

Ausbildung

High school diploma or equivalent

Jobbeschreibung

Primary Location South Campus Department Customer Service Shift Day (United States of America) Schedule Full time Weekly Hours 40 FTE 1 Employee Status Regular *Expected Starting Pay Range $18.66 - $22.89 *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 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 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