Professional Billing Finance Rep II

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

 

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