Cincinnati Children's Office of Academic Affairs and Career Development · 1 day ago
Professional Billing Claims Follow Up Rep II
Cincinnati, OH
Full-time
Onsite
Entry, Mid Level
$18/hr - $22/hr
2+ years expCincinnati Children's Office of Academic Affairs and Career Development is dedicated to improving children's health through a holistic team approach. The Professional Billing Claims Follow Up Rep II is responsible for managing the professional billing lifecycle, resolving claims and denials, and ensuring accurate financial operations to support the organization's revenue cycle.
Hospital & Health Care
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
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