Financial Clearance Rep I

Cincinnati Children's•Mount Vernon, VA

1d•$19 - $23

About The Position

The Financial Clearance Rep I works in the Financial Clearance Center and obtains pre-authorizations for scheduled services and medications using medical records and systems. The role involves collaborating with internal and external resources, contacting families before scheduled visits to confirm insurance eligibility and referrals, providing insurance-based estimates, following registration workflows, and maintaining a general understanding of billing processes. The representative manages work independently or with the team to meet productivity standards, accurately collects and verifies insurance and demographic information, obtains authorizations, and enters information into required systems. The role supports multiple divisions through cross-training and serves as a liaison among hospital and physician billing, admitting, outpatient surgery and departments, patient financial services, utilization review, and other Cincinnati Children's departments. The representative also contacts appropriate parties to resolve issues and escalates system errors and recurring problems identified in work queues or reports.

Requirements

High school diploma or equivalent.
No directly related experience required.

Responsibilities

Obtain pre-authorizations for scheduled services and medications using medical records and systems.
Collaborate with internal and external resources on authorization scenarios.
Contact families before scheduled visits to confirm insurance eligibility and referrals while minimizing stress.
Collect and provide insurance-based estimates and follow registration workflows.
Maintain a general understanding of billing processes.
Work independently and/or collaboratively to manage work volume and queues and meet or exceed productivity standards.
Accurately collect and verify insurance information and demographics, obtain insurance authorizations, and enter information into required systems.
Serve as a liaison among Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review, and other Cincinnati Children's departments.
Cross-train to provide insurance pre-authorization support for multiple divisions.
Contact appropriate internal and external parties to resolve issues.
Escalate system errors and recurring divisional problems or errors identified in work queues or reports.