Professional Billing Follow Up Rep II - Finance

Cincinnati Children's · United States

Primary Location South Campus Department Professional Billing Operation Shift Day (United States of America) Schedule Full time Weekly Hours 40 FTE 1 Employee Status Regular *Expected Starting Pay Range $18.16 - $22.25 *Starting pay is based on experience, skills, and equity; exceptions may apply for highly qualified candidates. Additional pay (e.g., shift, on‑call, or weekend differentials) and benefits may apply. Annual pay may vary based on FTE status. Position Summary The Professional Billing Representative supports the revenue cycle by ensuring accurate and timely billing, claim resolution, payment posting support, and account follow-up activities. This role works closely with internal departments, payers, and patients to resolve billing issues, reduce denials, and ensure compliance with organizational and regulatory requirements. What You'll Do

• Review and process professional claims for accuracy and completeness.
• Follow up on outstanding insurance claims and unpaid balances.
• Research and resolve claim denials, rejections, and payment discrepancies.
• Communicate with insurance carriers regarding claim status and reimbursement issues.
• Work with clinical and operational teams to obtain documentation needed for claim resolution.
• Maintain accurate account documentation within billing and practice management systems.
• Process adjustments, corrections, and rebilling activities as appropriate.
• Assist patients with billing questions and account inquiries.
• Meet productivity, quality, and account resolution goals.
• Maintain knowledge of payer guidelines, billing regulations, and revenue cycle best practices.

• Strong attention to detail and commitment to accuracy.
• Ability to manage multiple accounts and priorities simultaneously.
• Effective problem-solving and critical thinking skills.
• Strong written and verbal communication skills.
• Customer service mindset when working with patients and payers.
• Ability to work independently while collaborating with team members.

• High school diploma or equivalent.
• 2+ years of experience in healthcare billing, revenue cycle, insurance follow-up, accounts receivable, or a related field.
• Basic understanding of medical terminology, insurance plans, and billing workflows.
• Experience using electronic health record (EHR) and/or billing systems.

• Experience with professional (physician) billing.
• Experience working denial management and insurance follow-up.
• Knowledge of CPT, ICD-10, and HCPCS coding concepts.
• Experience with Epic or similar healthcare systems.
• Associate's degree in Business, Healthcare Administration, or a related field.

• Recognized by U.S. News & World Report as a top 10best Children's Hospitals in the nation for more than 15 years
• Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding
• Recognized as one of America’s Best Large Employers (2025), America’s Best Employers for New Grads (2025)
• One of the nation's America’s 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)