Professional Billing Follow Up Rep II

CO00 Children's Hospital Medical Center; United States; On-site; USD 35,000 - 55,000; Full time

Job summary

CO00 Children's Hospital Medical Center is looking for a qualified individual for a full-time position focusing on patient billing management. Responsibilities include preparing patient charges, processing claims, managing billing procedures, and liaising between departments to ensure accurate billing.

Applicants must possess a high school diploma and at least 2 years of related work experience. The position requires strong attention to detail and the ability to effectively manage patient billing and financial counseling.

Cincinnati Children’s is an Equal Opportunity Employer.

Qualifications

• 2+ years of work experience in a related discipline.

Responsibilities

• Compile and prepare patient charges.
• Prepare invoices and claim forms for third-party payers.
• Review charges for accuracy.
• Obtain payment evaluations from various resources.
• Manage patient billing procedures.
• Update departmental systems and information.
• Act as a preceptor for new employees.
• Liaise between departments and services.
• Counsel patients on coverage and financial matters.
• Determine eligibility for funding and complete paperwork.
• Coordinate admissions and synchronize with charge systems.
• Manage accounts receivable data.
• Research third-party charges.
• Conduct utilization reviews.
• Process and post payments accurately.
• Provide Quality Assurance reports.

Education

High school diploma or equivalent

Job description

Job Responsibilities

• Compile and prepare patient charges.
• Prepare invoices, billings, UB‑04 and 1500 claim forms for third‑party payers, outlining individual line items for services and total costs.
• Review charges and ensure accuracy.
• Obtain and evaluate family, third‑party payers, and agency resources for payment of charges.
• Manage patient billing and ensure procedures are billed according to contracts; transmit or mail all paper claims and review correspondence, following up as needed.
• Maintain and update departmental systems, templates, payer, and physician information.
• Act as a preceptor for new employees; provide instruction on non‑routine functions.
• Serve as liaison between Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, and other departments.
• Counsel patients on third‑party coverage and present financial aspects.
• Determine eligibility for State Medicaid, Social Security, and other outside funding; complete required paperwork for eligible patients.
• Coordinate inpatient and outpatient admissions; synchronize information with charge systems; input charges and relative data.
• Manage accounts receivable data and collection information, ensuring timeliness and accuracy.
• Research third‑party payers and community physician charges to maintain usual and customary charges and competitive pricing.
• Conduct utilization review for the division in conjunction with the Utilization Review department.
• Process, post, and balance payments to accounts promptly, accurately, and in the correct period.
• Provide Quality Assurance reports for the division.

Qualifications

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

Location: South Campus

Schedule: Full time Shift Day (United States of America)

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. Cincinnati Children’s is an Equal Opportunity Employer.