Remote Pre-Authorization Specialist II

CO00 Children's Hospital Medical Center; United States; Remote; USD 29,000 - 36,000; Full time

Job summary

Cincinnati Children’s is seeking a Financial Clearance Representative II to help patients and families access scheduled care by supporting insurance verification and pre-authorization. In this fully remote role, you will leverage payer knowledge, follow-up, and clear communication to resolve authorization and account issues while collaborating with multiple departments to ensure seamless patient access.

You will work in a centralized team, with a typical schedule of 40 hours per week, and

Qualifications

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

Responsibilities

• Efficiently obtain pre-authorizations for scheduled services and medications that require a moderate level of clinical knowledge.
• Collaborate with internal and external resources to resolve authorization scenarios and confirm insurance eligibility and referrals.
• Collect and verify insurance and demographic information, document authorization details, and update required systems accurately.
• Support billing-related follow-up, account updates, payer requirements, and first-level problem resolution for internal and external customers.
• Coordinate with billing, admitting, outpatient, patient financial services, utilization review, and other departments.
• Maintain departmental information and identify process improvement opportunities for management review.

Skills

Communication

Critical thinking

Attention to detail

Self-management

Collaboration

Education

High school diploma

Job description

Cincinnati Children’s is seeking a Financial Clearance Representative II to help patients and families access scheduled care by supporting insurance verification and pre-authorization. In this fully remote role, you will leverage payer knowledge, follow-up, and clear communication to resolve authorization and account issues while collaborating with multiple departments to ensure seamless patient access.

You will work in a centralized team, with a typical schedule of 40 hours per week, and