Senior Transplant Billing & Denials Specialist

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

Job summary

Cincinnati Children's is seeking a detail-oriented Billing Professional on the Primary Location South Campus to support the financial side of transplant care. The role handles insurance follow-up, denial management, and appeals, with cross-functional collaboration across Patient Financial Services and related departments.

Responsibilities include reviewing denials, preparing appeals, and ensuring payer requirements are met, while adhering to contracts and processing UB-04 and 1500 forms.

Qualifications

• High school diploma or equivalent.
• 3+ years of work experience in a related job discipline.
• Experience with insurance follow-up and denial processes.

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

Denial management

Payer requirements

Pattern recognition

Clear written communication

Cross-functional collaboration

Education

High school diploma or equivalent

Job description

Cincinnati Children's is seeking a detail-oriented Billing Professional on the Primary Location South Campus to support the financial side of transplant care. The role handles insurance follow-up, denial management, and appeals, with cross-functional collaboration across Patient Financial Services and related departments.

Responsibilities include reviewing denials, preparing appeals, and ensuring payer requirements are met, while adhering to contracts and processing UB-04 and 1500 forms.