Professional Billing Claims Follow Up Rep

Job Title

JOB RESPONSIBILITIES

Billing - Compile and prepare patient charges. Prepare invoices, UB-04 and 1500 claim forms to be sent to third party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed.

Systems Support - Maintain and update departmental system, including templates, and payer and physician information.

Collaboration - Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department / division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services and other Cincinnati Children's departments.

Financial Support - Obtain and evaluate family, third party payers and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payers and community physician charges in order to maintain usual and customary as well as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period.

Quality - Provide Quality Assurance reports for the division.

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

Market Leading Benefits Including :

Medical coverage starting day one of employment

Competitive retirement plans

Tuition reimbursement for continuing education

Expansive employee discount programs through our many community partners

Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions

Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic / Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group

Physical and mental health wellness programs

Relocation assistance available for qualified positions

Benefits may vary based on FTE Status and Position Type

About Us

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