Job Responsibilities
Own the Facility Billing Process (UB-04) Prepare, review, and submit hospital (UB-04) claims for inpatient, outpatient, and procedural services. Validate that charges, units, revenue codes, modifiers, and documentation are correct and complete before submission. Scrub claims and correct edits related to coverage, coding, authorization, medical necessity, or clinical documentation. Review rejections and resolve issues to ensure timely, compliant claim submission. Manage Hospital Accounts Receivable With Precision Conduct thorough follow-up with third-party payers on outstanding or denied hospital accounts. Research payer rules and reimbursement methodologies (DRG, APC, per diem, carve-outs) and apply them to claim resolution. Resolve inpatient and outpatient claim discrepancies quickly to reduce AR aging. Process, post, and balance payments and adjustments accurately and in the correct period. Support Charge Capture & Revenue Integrity Coordinate closely with inpatient, outpatient, emergency, and procedural areas to validate accurate charge entry. Identify missing, incorrect, or duplicate charges and collaborate with departments to correct them. Assist with maintaining and updating the hospital charge master, ensuring rates, codes, and descriptions stay accurate and competitive. Strengthen Billing Operations & Systems Maintain and update billing templates, payer information, and physician/departmental billing requirements. Ensure information flows correctly between charge systems, billing systems, and payer portals. Support system updates and test new workflows that improve speed, accuracy, or compliance. Collaborate Across Departments Act as a liaison between Hospital Billing Operations and key departments such as Access Services, Admitting, Outpatient Surgery, Outpatient Departments, Payer Relations, Cash Applications, and Physician Billing Services. Provide insight on payer requirements and help clinical teams understand how documentation impacts reimbursement. Assist as a resource for new team members and serve as a subject matter expert for non-routine billing situations. Maintain the Highest Quality Standards Produce and review quality assurance reports to ensure billing accuracy and compliance. Support utilization review activities by coordinating with UR teams and payers as needed. Uphold integrity and compliance across all billing actions, following hospital and regulatory guidelines. Why This Role Matters You help ensure Cincinnati Children's receives accurate reimbursement - supporting the lifesaving care we provide every day. Your work: Reduces financial stress for families Supports operational excellence and compliance Ensures clinical documentation is reflected correctly Helps maintain the hospital's financial strength and sustainability You're not just billing - you're part of the care team. 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 Hospital Billing Operations Employee Status Regular FTE 1 Weekly Hours 40 Expected Starting Pay Range Annualized pay may vary based on FTE status $18.16 - $22.25 About Us At Cincinnati Children's, we come to work with one goal in mind: to make children better today and healthier tomorrow.
Own the Facility Billing Process (UB-04) Prepare, review, and submit hospital (UB-04) claims for inpatient, outpatient, and procedural services. Validate that charges, units, revenue codes, modifiers, and documentation are correct and complete before submission. Scrub claims and correct edits related to coverage, coding, authorization, medical necessity, or clinical documentation. Review rejections and resolve issues to ensure timely, compliant claim submission. Manage Hospital Accounts Receivable With Precision Conduct thorough follow-up with third-party payers on outstanding or denied hospital accounts. Research payer rules and reimbursement methodologies (DRG, APC, per diem, carve-outs) and apply them to claim resolution. Resolve inpatient and outpatient claim discrepancies quickly to reduce AR aging. Process, post, and balance payments and adjustments accurately and in the correct period. Support Charge Capture & Revenue Integrity Coordinate closely with inpatient, outpatient, emergency, and procedural areas to validate accurate charge entry. Identify missing, incorrect, or duplicate charges and collaborate with departments to correct them. Assist with maintaining and updating the hospital charge master, ensuring rates, codes, and descriptions stay accurate and competitive. Strengthen Billing Operations & Systems Maintain and update billing templates, payer information, and physician/departmental billing requirements. Ensure information flows correctly between charge systems, billing systems, and payer portals. Support system updates and test new workflows that improve speed, accuracy, or compliance. Collaborate Across Departments Act as a liaison between Hospital Billing Operations and key departments such as Access Services, Admitting, Outpatient Surgery, Outpatient Departments, Payer Relations, Cash Applications, and Physician Billing Services. Provide insight on payer requirements and help clinical teams understand how documentation impacts reimbursement. Assist as a resource for new team members and serve as a subject matter expert for non-routine billing situations. Maintain the Highest Quality Standards Produce and review quality assurance reports to ensure billing accuracy and compliance. Support utilization review activities by coordinating with UR teams and payers as needed. Uphold integrity and compliance across all billing actions, following hospital and regulatory guidelines. Why This Role Matters You help ensure Cincinnati Children's receives accurate reimbursement - supporting the lifesaving care we provide every day. Your work: Reduces financial stress for families Supports operational excellence and compliance Ensures clinical documentation is reflected correctly Helps maintain the hospital's financial strength and sustainability You're not just billing - you're part of the care team. 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 Hospital Billing Operations Employee Status Regular FTE 1 Weekly Hours 40 Expected Starting Pay Range Annualized pay may vary based on FTE status $18.16 - $22.25 About Us At Cincinnati Children's, we come to work with one goal in mind: to make children better today and healthier tomorrow.