Senior Transplant Billing & Denial Specialist

Cincinnati Children's; Mount Vernon (VA); On-site; USD 29,000 - 36,000; Full time

Job summary

Cincinnati Children’s Hospital is seeking a billing specialist to support complex transplant-related revenue cycle activities. You will follow up with payers, review denials, prepare appeals, and manage claims including UB-04 and 1500 forms.

Collaborative, cross-functional teamwork is essential in this role. The position offers full-time hours, day shifts, and competitive starting pay with additional pay differentials.

Qualifications

• High school diploma or equivalent.
• 3+ years of work experience in a related job discipline.
• Insurance follow-up experience.
• Experience handling denials, disputes, or appeals.
• Experience with hospital/physician billing.
• Knowledge of cash posting or payment activity.
• Transplant billing experience is helpful but not required.
• Experience with multiple payer types.

Responsibilities

• Follow up with commercial, Medicaid, and other payers to secure appropriate payment.
• Review and work claim denials, identify next steps, and prepare or support appeals.
• Analyze account activity, correspondence, payment information, and payer requirements.
• Compile and prepare patient charges and claims, including UB-04 and 1500 claim forms, as applicable.
• Manage billing according to contracts and follow up on outstanding correspondence or account needs.
• Perform specialized level III work and serve as a resource on non-routine situations.
• Collaborate with Physicians Billing Service, Admitting, outpatient areas, Patient Financial Services, and other departments.
• Participate in quality improvement, research, analysis, corrective action, and system improvement efforts.

Skills

Insurance follow-up

Denials management

Appeals

Payer communication

Education

High school diploma or equivalent

Job description

Cincinnati Children’s Hospital is seeking a billing specialist to support complex transplant-related revenue cycle activities. You will follow up with payers, review denials, prepare appeals, and manage claims including UB-04 and 1500 forms.

Collaborative, cross-functional teamwork is essential in this role. The position offers full-time hours, day shifts, and competitive starting pay with additional pay differentials.