Professional Billing Claims Follow Up Rep II

Cincinnati Children's • Madison, WI

4d • $18 - $22 • Onsite

About The Position

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.

Requirements

• High school diploma or equivalent
• 2+ years of work experience in a related job discipline

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees