Financial Clearance Representative I
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Job Description
Financial Clearance Representative securing insurance authorizations and verifying coverage for Cincinnati Children’s pediatric healthcare services. Supporting families, billing teams, and multiple hospital divisions.
Responsibilities:
- Efficiently obtain pre-authorizations for scheduled services and medications using medical records and systems
- Collaborate with internal and external resources on authorization scenarios
- Contact families before scheduled visits to confirm insurance eligibility and referrals
- Collect and provide insurance-based estimates while adhering to registration workflows
- Handle work volume and queues to meet or exceed productivity standards
- Collect and verify insurance information and demographics, obtain insurance authorization, and enter information into required systems
- Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review, and other Cincinnati Children's departments
- Support multiple divisions and cross-train to work insurance pre-authorization for multiple divisions
- Initiate calls to appropriate internal and external parties to resolve issues
- Escalate system errors and recurring divisional problems identified within work queues or reports
Requirements:
- High school diploma or equivalent
- No directly related experience required
- Ability to obtain pre-authorizations for scheduled services and medications using medical records and systems
- Ability to accurately collect and verify insurance information and demographics
- Ability to enter information into required systems
- General understanding of billing processes
- Ability to work independently and collaboratively
- Ability to resolve issues with internal and external parties
- Ability to escalate system errors and recurring problems appropriately
Benefits:
- Additional pay may apply, including shift, on-call, or weekend differentials
- Benefits may apply
- Full-time schedule with 40 weekly hours
- Regular employee status
- Support for responsible use of artificial intelligence and innovation
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