Financial Clearance Representative II

Cincinnati Children's Hospital Medical Center; Cincinnati (OH); Remote; USD 29,000 - 36,000; Full time

Job summary

Cincinnati Children’s Hospital Medical Center is seeking a Financial Clearance Representative II for a fully remote role. You will help verify insurance, obtain pre-authorizations, and support billing and account resolution with payers and internal teams.

The position requires a high school diploma and at least 2 years in a related role, with preferred experience in insurance authorizations and medical billing.

Qualifications

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

Responsibilities

• Efficiently obtain pre-authorizations for scheduled services and medications that require a moderate level of clinical knowledge.
• Collaborate with internal and external resources to resolve authorization scenarios and confirm insurance eligibility and referrals.
• Collect and verify insurance and demographic information, document authorization details, and update required systems accurately.
• Support billing-related follow-up, account updates, payer requirements, and first-level problem resolution for internal and external customers.
• Coordinate with billing, admitting, outpatient, patient financial services, utilization review, and other departments.
• Maintain departmental information and identify process improvement opportunities for management review.

Skills

Communication

Critical thinking

Organization

Self-management

Education

High school diploma

Job description

Primary LocationRemoteDepartmentCentralized Pre-authorizationShiftDay (United States of America)ScheduleFull timeWeekly Hours40FTE1Employee StatusRegular*Expected Starting Pay Range$21.14 - $26.47*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.

Financial Clearance Representative II

Help patients and families move toward scheduled care by supporting accurate insurance verification and pre-authorization. In this fully remote role, you will combine payer knowledge, organized follow-up, clear communication, and thoughtful problem-solving to help resolve authorization and account issues.

What You Will Do

• Efficiently obtain pre-authorizations for scheduled services and medications that require a moderate level of clinical knowledge.
• Collaborate with internal and external resources to resolve authorization scenarios and confirm insurance eligibility and referrals.
• Collect and verify insurance and demographic information, document authorization details, and update required systems accurately.
• Support billing-related follow-up, account updates, payer requirements, and first-level problem resolution for internal and external customers.
• Coordinate with billing, admitting, outpatient, patient financial services, utilization review, and other departments.
• Maintain departmental information and identify process improvement opportunities for management review.

What Will Help You Be Successful

• Clear, professional communication with families, payers, and internal partners.
• Critical thinking and the ability to investigate issues, follow up, and elevate appropriately.
• Strong organization, attention to detail, and the ability to self-manage work in a remote setting.
• Comfort working independently and collaboratively while maintaining accurate documentation and quality expectations.

Job Qualifications

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

Preferred Qualifications

• Minimum of 6 months of experience with insurance authorizations.
• Experience with medical billing, collections on medical claims, or denial follow-up/disputes.
• Exposure to medical coding concepts, including diagnosis and CPT information.
• Experience in patient access or related healthcare revenue cycle work.

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