Authorization & Revenue Cycle Lead

Jobtailor; Garden Grove (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Jobtailor is seeking a healthcare Revenue Cycle specialist to lead and optimize insurance authorization workflows in California, ensuring timely payer authorizations and reducing denials. You will collaborate with payers and internal teams to scale processes, monitor performance, and implement policy changes across EHR and practice management systems.

Strong communication and project leadership are essential.

Qualifications

• High school diploma or GED required.
• 5+ years of experience in healthcare revenue cycle, insurance authorizations, medical billing, or related operations.
• Experience with insurance authorization processes and payer requirements.
• Experience with EHR, practice management, and/or medical billing systems.
• Understanding of reimbursement processes and link between authorizations, claims, and denials.
• Experience developing or improving healthcare workflows and processes.
• Proficient with computers, email, virtual platforms, and MS Office.
• Preferred: Medi-Cal, CalAIM programs, and eCW experience.

Responsibilities

• Support development, implementation, and integration of authorization workflows within Revenue Cycle.
• Manage complex authorization processes and ensure services are authorized within payer timeframes.
• Monitor authorization workflows, work queues, turnaround times, and expiring authorizations.
• Interpret payer requirements and incorporate into workflows.
• Resolve missing or expiring authorizations with operational teams.
• Identify issues contributing to denials and revenue loss; collaborate to resolve.
• Develop processes to reduce denials and prevent revenue loss.
• Support integration of authorization functions into Revenue Cycle, including documentation and policies.
• Lead and coordinate complex authorization projects, timelines, and deliverables.
• Analyze processes and performance trends to improve efficiency and reimbursement.
• Coordinate with Revenue Cycle, Finance, Data, and leadership to resolve issues.
• Oversee processing of Community Supports housing-related deposits and timely documentation.
• Communicate process changes and payer requirements to stakeholders.

Skills

Insurance authorization processes

Payer requirements

Workflow improvement

Project management

Data analysis

Communication skills

Attention to detail

Organizational skills

Problem solving

Education

Associate or bachelor's degree in healthcare administration, business administration, finance, or related field

Tools

Electronic Health Record (EHR)

Practice Management Systems

Microsoft Office

EClinicalWorks (eCW)

Virtual Platforms

Job description

Jobtailor is seeking a healthcare Revenue Cycle specialist to lead and optimize insurance authorization workflows in California, ensuring timely payer authorizations and reducing denials. You will collaborate with payers and internal teams to scale processes, monitor performance, and implement policy changes across EHR and practice management systems.

Strong communication and project leadership are essential.