Professional Billing Claims Follow Up Rep

Job Responsibilities

Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd 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.

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

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 Childrens departments.

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. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Childrens Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period.

Provide Quality Assurance reports for the division.

Job Qualifications

High school diploma or equivalent

2+ years of work experience in a related job discipline

About Us

At Cincinnati Childrens, we come to work with one goal : to make childrens health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Childrens.

Cincinnati Childrens is :

• Recognized by U.S. News & World Report as a top 10 best Childrens Hospitals in the nation for more than 15 years
• Consistently among the top 3 Childrens Hospitals for National Institutes of Health (NIH) Funding
• Recognized as one of Americas Best Large Employers (2025), Americas Best Employers for New Grads (2025)
• One of the nations Americas Most Innovative Companies as noted by Fortune
• Consistently certified as great place to work
• A Leading Disability Employer as noted by the National Organization on Disability
• Magnet designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC)

We Embrace InnovationTogether. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger futurefor all of us.

Comprehensive job description provided upon request.

Cincinnati Childrens is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO / Veteran / Disability