Professional Billing Follow Up Rep II

Cincinnati Children's Hospital Medical Center; Cincinnati (OH); On-site; USD 25,000 - 31,000; Full time

Job summary

Cincinnati Children's Hospital Medical Center is seeking a Billing Specialist for the Professional Billing Operation at South Campus. This role handles compiling and preparing patient charges, UB-04 and 1500 forms, and ensuring charges align with contracts and payer requirements.

The candidate will support systems updates, act as a resource within the department, and assist with utilization reviews and AR data management. A high school diploma and 2+ years of related experience are required.

Qualifications

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

Responsibilities

• Compile and prepare patient charges and invoices for third-party payers.
• Maintain departmental billing systems and templates.
• Coordinate with physicians, admissions, Outpatient Surgery, and other departments to ensure accurate charges.
• Provide quality assurance reports for the division.
• Counsel families on financial aspects and determine eligibility for Medicaid and other funding.

Skills

Billing processes

Education

High school diploma or equivalent

Job description

JOB RESPONSIBILITIES

• 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.
• Systems Support - Maintain and update departmental system, including templates, and payer and physician information.
• Collaboration - Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments.
• Financial Support - Obtain and evaluate family, third party payers and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payers and community physician charges in order to maintain usual and customary as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period.
• Quality - Provide Quality Assurance reports for the division.

JOB QUALIFICATIONS

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

Primary Location: South Campus

Schedule: Full time

Shift: Day (United States of America)

Department: Professional Billing Operation

Employee Status: Regular

FTE: 1

Weekly Hours: 40

*Expected Starting Pay Range*: Annualized pay may vary based on FTE status $18.16 - $22.25

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'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