Financial Clearance Representative I - Hybrid

Cincinnati Children's•Mount Vernon, VA

1d•$19 - $23•Hybrid

About The Position

The Financial Clearance Representative I obtains pre-authorizations for scheduled services and medications, using medical records and relevant systems. The role collaborates with internal and external resources on authorization scenarios and contacts families before scheduled visits to confirm insurance eligibility and referrals. It also provides or collects insurance-based estimates, follows registration workflows, and maintains a general understanding of billing processes. The representative works independently and with a team to manage work volume and queues efficiently, meeting or exceeding productivity standards. The position verifies insurance and demographic information, obtains insurance authorization, and enters information into required systems. It 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 is cross-trained to support insurance pre-authorization across multiple divisions and helps resolve issues by contacting relevant parties and escalating system errors or recurring problems as appropriate.

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.
Collect and provide insurance-based estimates, follow registration workflows, and maintain a general understanding of billing processes.
Manage work volume and queues independently or collaboratively to meet or exceed productivity standards.
Accurately collect and verify insurance information and demographics, obtain insurance authorization, 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 work on insurance pre-authorizations 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 to appropriate staff.