About this role
JOB RESPONSIBILITIES
✔ Own the Professional Billing Lifecycle
- Prepare, review, and submit accurate professional claims using Epic and payer-specific tools.
- Scrub claims to ensure correct codes, units, modifiers, authorizations, and documentation are present before submission.
- Review and resolve edits, rejections, and payer error responses including coding inconsistencies or missing information.
✔ Lead Payer Follow-Up & Claims Resolution
Conduct timely follow-up with insurance carriers to resolve outstanding claims.
- Investigate denials (technical and clinical), coordinate corrections, and resubmit claims as needed.
- Identify trends in payer behavior to reduce preventable denials and accelerate reimbursement cycles.
✔ Deliver High-Quality Financial Accuracy
- Process, post, and balance payments, adjustments, and payer responses with precision.
- Monitor accounts receivable and escalate complex claim issues using established workflows.
- Support charge review and address discrepancies proactively to avoid downstream billing issues.
✔ Strengthen Billing Operations & Systems
- Maintain and update provider, payer, and billing templates in departmental systems.
- Assist with charge master maintenance to ensure accuracy and competitiveness.
- Support system updates and workflow enhancements that improve billing efficiency.
✔ Collaborate Across the Organization
- Partner closely with clinic teams, coding, Physician Billing Services, Admitting, Financial Services, Payer Relations, and others to ensure complete and compliant claims.
- Provide guidance to peers and act as a resource for non-routine billing functions.
- Support onboarding of new team members as a preceptor or subject matter resource when needed.
Why This Role Matters
Professional billing is complex — but the stakes are high. Your attention to detail helps:
- Secure reimbursement that sustains Cincinnati Children’s world‑leading care
- Ensure providers are paid accurately for their work
- Reduce stress and uncertainty for families
- Enhance compliance and avoid preventable revenue loss
Your expertise contributes to a revenue cycle that operates with integrity, efficiency, and compassion.
JOB QUALIFICATIONS
High school diploma or equivalent
2+ years of work experience in a related job discipline
Primary Location
South Campus
Schedule
Full time
Shift
Day (United States of America)
Department
Professional Billing Operation
Employee Status
Regular
FTE
1
Weekly Hours
40
Expected Starting Pay Range
Annualized pay may vary based on FTE status
$18.16 - $22.25
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 a top 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 New Grads (2025)
One of the nation's America’s Most Innovative Companies as noted by Fortune
Consistently certified as great place to work
A Leading Disability Employer as noted by the National Organization on Disability
Magnet® designated for the fourth consecutive time by the American Nurses Credentialing Center (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 all of us.
Comprehensive job description provided upon request.
Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. 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. EEO/Veteran/Disability
Other facts
About Cincinnati Children's
Cincinnati Children’s, a nonprofit academic medical center established in 1883, offers services from well-child care to treatment for the most rare and complex conditions. It is the Department of Pediatrics at the University of Cincinnati College of Medicine and trains more than 600 residents and clinical fellows each year. Cincinnati Children’s is a force in pediatric research and offers some of the best research-based education and training programs in the nation.
Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. 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. EEO/Veteran/Disability
What you'll do
- The role involves managing the professional billing lifecycle, including preparing and submitting claims, resolving edits and rejections, and conducting follow-ups with insurance carriers. Additionally, the representative will monitor accounts receivable and collaborate with various teams to ensure compliance and accuracy in billing.
Ready to join Cincinnati Children's?
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