Professional Billing Follow Up Rep II - Finance

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 Professional Billing Representative for the South Campus. The role supports revenue cycle through timely billing, claim resolution, payment posting, and follow-up with payers and patients.

Responsibilities include reviewing claims, following up on denials, and ensuring documentation for resolution while meeting productivity and quality goals. A background in healthcare billing and EHR proficiency are required.

Qualifications

• High school diploma or equivalent.
• 2+ years of healthcare billing or related experience.
• Basic understanding of medical terminology, insurance plans, and billing workflows.
• Experience using EHR and/or billing systems.

Responsibilities

• Review and process professional claims for accuracy and completeness.
• Follow up on outstanding insurance claims and unpaid balances.
• Research and resolve claim denials, rejections, and payment discrepancies.
• Communicate with insurance carriers regarding claim status and reimbursement issues.
• Work with clinical and operational teams to obtain documentation for claim resolution.
• Maintain accurate account documentation within billing and practice management systems.
• Process adjustments, corrections, and rebilling activities as appropriate.
• Assist patients with billing questions and account inquiries.
• Meet productivity, quality, and account resolution goals.
• Maintain knowledge of payer guidelines, billing regulations, and revenue cycle best practices.

Skills

Attention to detail

Multitasking

Problem solving

Communication

Customer service

Independent work

Education

Associate's degree in Business or Healthcare Administration

Tools

EHR systems

Epic

Billing systems

Job description

Primary Location

South Campus

Department

Professional Billing Operation

Shift

Day (United States of America)

Schedule

Full time

Weekly Hours

40

FTE

1

Employee Status

Regular*

Expected Starting Pay Range

$18.16 - $22.25*

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.

Position Summary

The Professional Billing Representative supports the revenue cycle by ensuring accurate and timely billing, claim resolution, payment posting support, and account follow-up activities. This role works closely with internal departments, payers, and patients to resolve billing issues, reduce denials, and ensure compliance with organizational and regulatory requirements.

What You'll Do

• Review and process professional claims for accuracy and completeness.
• Follow up on outstanding insurance claims and unpaid balances.
• Research and resolve claim denials, rejections, and payment discrepancies.
• Communicate with insurance carriers regarding claim status and reimbursement issues.
• Work with clinical and operational teams to obtain documentation needed for claim resolution.
• Maintain accurate account documentation within billing and practice management systems.
• Process adjustments, corrections, and rebilling activities as appropriate.
• Assist patients with billing questions and account inquiries.
• Meet productivity, quality, and account resolution goals.
• Maintain knowledge of payer guidelines, billing regulations, and revenue cycle best practices.

What Will Help You Be Successful

• Strong attention to detail and commitment to accuracy.
• Ability to manage multiple accounts and priorities simultaneously.
• Effective problem-solving and critical thinking skills.
• Strong written and verbal communication skills.
• Customer service mindset when working with patients and payers.
• Ability to work independently while collaborating with team members.

Minimum Qualifications

• High school diploma or equivalent.
• 2+ years of experience in healthcare billing, revenue cycle, insurance follow-up, accounts receivable, or a related field.
• Basic understanding of medical terminology, insurance plans, and billing workflows.
• Experience using electronic health record (EHR) and/or billing systems.

Preferred Qualifications

• Experience with professional (physician) billing.
• Experience working denial management and insurance follow-up.
• Knowledge of CPT, ICD-10, and HCPCS coding concepts.
• Experience with Epic or similar healthcare systems.
• Associate's degree in Business, Healthcare Administration, or a related field.

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 NewGrads (2025) Oneofthe nation'sAmerica’sMost InnovativeCompanies as noted by Fortune Consistently certifiedas great place to work A Leading Disability Employer as noted by the National OrganizationonDisability Magnetdesignated for the fourth consecutive time bythe AmericanNursesCredentialingCenter (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 allofus. Comprehensive jobdescriptionprovideduponrequest. Cincinnati Children's is proudtobe an EqualOpportunityEmployer committed to creating an environmentofdignityandrespect forallour employees, patients,andfamilies. All qualified applicantswillreceive considerationfor employment withoutregardto race, color, religion, sex, age, genetic information, nationalorigin, sexual orientation, gender identity, disability or protectedveteranstatus. EEO/Veteran/Disability