Healthcare Revenue Cycle Specialist

Cincinnati Children's; Cincinnati (OH); On-site; USD 34,000 - 42,000; Full time

Job summary

Cincinnati Children’s is seeking a full-time Billing Specialist at the College Hill campus to manage patient charges, prepare invoices, verify benefits, secure authorizations, and communicate with families about coverage and liability. The role emphasizes accuracy, regulatory compliance, and cross-team collaboration.

The starting pay range is $24.56–$30.75 per hour, based on experience, with potential differentiations and annual variation with FTE status.

Qualifications

• High school diploma or equivalent
• Preferred: Bachelor's degree
• 3+ years related experience
• Preferred: Coding certification
• Preferred: 2+ years related experience in healthcare system revenue cycle settings

Responsibilities

• Financial Responsibility - May have specialized areas of responsibility (e.g. government & non-government billing, appeal processing, review & approval of refunds in addition to coding corrections, etc.). May manage specialized work queues independently due to knowledge and unique system security clearance.
• System Support - Identify system and technology needs. Participate in advancing use of technology. Ensures systems meet all regulatory and compliance requirements. Perform tasks which require higher level of security access. May lead in testing, install updates and act as the liaison with the vendor to make appropriate programming changes and solve systems issues.
• Billing - Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed. Ensure insurance verification of benefits, eligibility and plan participation. Secure authorizations with supporting documentation as needed. Communicate with families on coverage and out-of-pocket liability. Process insurance changes.
• Collaboration - Perform duties in support of team members¿ daily operations, problem solving, projects, and communications with payor representatives. Supplement training beyond training on services, systems and payor specifics. Perform specialty services functions and may direct daily activities for specific work functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Billing and Coding Services, Admitting, Outpatient Surgery, Outpatient Department, and other Cincinnati Children's departments. May have supervisory responsibilities.
• Quality - May perform research and analysis. Participate in departmental/division performance improvement and quality assurance controls. May perform account audits and develop and execute corrective actions plans. Participate in LEAN Collaboratives and partner with the clinic team to research and solve systemic problems.

Job description

Cincinnati Children’s is seeking a full-time Billing Specialist at the College Hill campus to manage patient charges, prepare invoices, verify benefits, secure authorizations, and communicate with families about coverage and liability. The role emphasizes accuracy, regulatory compliance, and cross-team collaboration.

The starting pay range is $24.56–$30.75 per hour, based on experience, with potential differentiations and annual variation with FTE status.