BMT Financial Clearance Rep III

• Expected Starting Pay Range $22.18 - $27.73
• 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.

South Campus

Financial Clearance Center

Day (United States of America)

Full time

40

1

Regular

• Expected Starting Pay Range $22.18 - $27.73
• 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 access to highly complex bone marrow transplant care by coordinating financial clearance, prior authorizations, and payer requirements across the full patient journey. In this role, you will partner closely with care teams, providers, insurers, and revenue cycle colleagues to keep high-value, time-sensitive cases moving accurately and clearly.

• Obtain pre-authorizations for complex scheduled services, medications, HLA typing, bone marrow transplant services, and related care using medical records, Epic, and payer portals.
• Manage daily appointment and authorization work queues while tracking dates, clinical submissions, payer requirements, and follow-up actions.
• Coordinate with care managers, providers, insurers, billing teams, and other internal partners to resolve authorization, eligibility, referral, contract, and coverage issues.
• Communicate authorization status and next steps primarily by email, with phone outreach to insurers and occasional support for patients and families when escalation is needed.
• Collect and verify insurance and demographic information, document accurately in required systems, and maintain a working understanding of billing processes.
• Serve as a resource for complex authorization questions, identify recurring payer issues, and share improvement opportunities with leadership.
• Cross-train across department and division authorization processes and support team workload as needed.

• Strong organization and follow-through across long-running cases with multiple dates and dependencies.
• Clear, professional communication with clinical teams, providers, insurers, internal partners, patients, and families.
• Comfort interpreting payer requirements, submitting clinical information, and using authorization portals.
• Sound judgment when working through complex or conflicting information and escalating when appropriate.
• Ability to balance independent work, productivity expectations, accuracy, and collaboration.

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

• Minimum of 1 year of experience with insurance authorizations.
• Experience in insurance billing, revenue cycle, financial clearance, or customer service involving payer questions.
• Experience supporting complex medication, oncology, hematology, transplant, or other clinically detailed authorizations.
• Familiarity with Epic and payer authorization portals.
• Clinical exposure is helpful but is not required.

This team follows a hybrid work model with an in-office day on Tuesdays. The role uses Epic, email, phone communication, and payer portals. The interview process is expected to be virtual.

At Cincinnati Children’s, we come to work with one goal: to make children’s 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…