Insurance Verifcation Rep II

Cincinnati Children's•Augusta, GA

8d•$21 - $26•Hybrid

About The Position

Help support timely access to care by verifying coverage, coordinating pre-authorizations, and resolving insurance-related issues for scheduled services. This role supports a high-volume pediatric surgery environment and partners across teams to keep accounts accurate and families informed with minimal stress.

Requirements

High school diploma or equivalent.
2+ years of work experience in a related job discipline.
Comfort working in a high-volume, fast-moving environment.
Clear communication and organized follow-through across multiple stakeholders.
Ability to interpret routine payer requirements, use sound judgment, and escalate appropriately.
Attention to detail when reviewing records, insurance data, authorizations, and account updates.

Nice To Haves

Experience with insurance verification, pre-authorization, or related healthcare revenue cycle work.
Familiarity with insurance portals, CPT codes, diagnosis or ICD-10 codes, and Epic.
Experience handling work queues or supporting multiple clinical divisions in a high-volume setting.

Responsibilities

Collect and verify insurance and demographic information, obtain required authorizations, and enter information accurately in designated systems.
Review payer requirements and medical records to gather clinical support for pre-authorizations for scheduled services and medications.
Serve as a first point of problem resolution for internal and external customers, escalating system or recurring issues when appropriate.
Coordinate with billing, admitting, outpatient, patient financial services, utilization review, clinical teams, payers, and families.
Maintain payer and provider information, identify process-improvement opportunities, and share payer trends with the team.
Manage work queues independently and collaboratively to meet quality and productivity expectations.