Cincinnati Children's Office of Academic Affairs and Career Development · 23 hours ago
Finance Rep II
Cincinnati, OH
Full-time
Onsite
Entry, Mid Level
2+ years expCincinnati Children's Office of Academic Affairs and Career Development is dedicated to improving children's health. The Finance Rep II is responsible for managing the facility billing process, ensuring accurate claims submission, and collaborating across departments to maintain billing integrity.
Hospital & Health Care
Responsibilities
Own the Facility Billing Process (UB‑04)
Prepare, review, and submit hospital (UB‑04) claims for inpatient, outpatient, and procedural services
Validate that charges, units, revenue codes, modifiers, and documentation are correct and complete before submission
Scrub claims and correct edits related to coverage, coding, authorization, medical necessity, or clinical documentation
Review rejections and resolve issues to ensure timely, compliant claim submission
Manage Hospital Accounts Receivable With Precision
Conduct thorough follow‑up with third‑party payers on outstanding or denied hospital accounts
Research payer rules and reimbursement methodologies (DRG, APC, per diem, carve-outs) and apply them to claim resolution
Resolve inpatient and outpatient claim discrepancies quickly to reduce AR aging
Process, post, and balance payments and adjustments accurately and in the correct period
Support Charge Capture & Revenue Integrity
Coordinate closely with inpatient, outpatient, emergency, and procedural areas to validate accurate charge entry
Identify missing, incorrect, or duplicate charges and collaborate with departments to correct them
Assist with maintaining and updating the hospital charge master, ensuring rates, codes, and descriptions stay accurate and competitive
Strengthen Billing Operations & Systems
Maintain and update billing templates, payer information, and physician/departmental billing requirements
Ensure information flows correctly between charge systems, billing systems, and payer portals
Support system updates and test new workflows that improve speed, accuracy, or compliance
Collaborate Across Departments
Act as a liaison between Hospital Billing Operations and key departments such as Access Services, Admitting, Outpatient Surgery, Outpatient Departments, Payer Relations, Cash Applications, and Physician Billing Services
Provide insight on payer requirements and help clinical teams understand how documentation impacts reimbursement
Assist as a resource for new team members and serve as a subject matter expert for non‑routine billing situations
Maintain the Highest Quality Standards
Produce and review quality assurance reports to ensure billing accuracy and compliance
Support utilization review activities by coordinating with UR teams and payers as needed
Uphold integrity and compliance across all billing actions, following hospital and regulatory guidelines
Qualification
Required
High school diploma or equivalent
2+ years of work experience in a related job discipline
Company
Cincinnati Children's Office of Academic Affairs and Career Development
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Cincinnati, Ohio, US
5001-10000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase