Insurance Verifcation Rep II

Cincinnati Children's · United States

Primary Location South Campus Department Customer Service Shift Day (United States of America) Schedule Full time Weekly Hours 40 FTE 1 Employee Status Regular *Expected Starting Pay Range $20.57 - $25.72 *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. 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. What You Will Do

• 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.

• 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.

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

• 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.

• 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)