Hybrid Financial Clearance Lead for Complex Transplants

Cincinnati Children's Office of Academic Affairs and Career Development; Cincinnati (OH); Ibrido; USD 46.000 - 58.000; Tempo pieno

Descrizione del lavoro

Cincinnati Children’s is seeking a BMT Financial Clearance Rep III to support access to highly complex care by coordinating pre-authorizations and payer requirements. You will partner with care teams, insurers, and revenue cycle colleagues to keep high-value cases moving accurately.

The role emphasizes strong organization, professional communication, and ability to interpret payer requirements using Epic and payer portals. A hybrid in-office presence is required.

Competenze

• High school diploma or equivalent.
• 3+ years of work experience in a related job discipline.
• Experience with insurance authorizations is preferred.

Mansioni

• 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.

Conoscenze

Organization

Communication

Attention to detail

Team collaboration

Formazione

High school diploma or equivalent

3+ years of related work experience

Strumenti

Epic

Payer portals

Descrizione del lavoro

Cincinnati Children’s is seeking a BMT Financial Clearance Rep III to support access to highly complex care by coordinating pre-authorizations and payer requirements. You will partner with care teams, insurers, and revenue cycle colleagues to keep high-value cases moving accurately.

The role emphasizes strong organization, professional communication, and ability to interpret payer requirements using Epic and payer portals. A hybrid in-office presence is required.