Lead, Pediatric Authorization & Revenue Cycle

Care Options for Kids; Pennsylvania; On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health insurance

Paid Time Off

401K

Job summary

Care Options for Kids in Pennsylvania seeks a Lead, Revenue Cycle - Authorization Services to oversee a small team of Authorization Specialists and manage prior authorizations for in-home pediatric services across Medicaid, Medicare Advantage, and commercial payers. The role requires PA payer policy expertise, strong analytics, and a drive to reduce delays.

You will mentor staff, perform audits, and collaborate with Billing, Clinical Operations, and Branch Leadership to improve access and

Qualifications

• Deep knowledge of PA payer authorization requirements (Medicaid MCOs, Medicare Advantage, commercial payers).
• Experience leading authorization workflows in healthcare or revenue cycle environments.
• Ability to audit, mentor, and drive process improvements and compliance.

Responsibilities

• Oversee a designated payer group and coach a small team of Authorization Specialists.
• Obtain prior authorizations, pre-certifications, and continued stay approvals for in-home pediatric services.
• Monitor status, follow up with payers, and drive timely resolution to prevent delays.
• Analyze trends and payer performance to improve authorization success and revenue cycle outcomes.
• Document activity in EMR and revenue cycle platforms, ensuring data integrity.
• Partner with Revenue Cycle, Clinical Operations, Billing, and Branch Leadership to remove barriers.

Skills

Leadership

Team management

Revenue cycle

Data analytics

Automation mindset

Tools

EMR systems

Payer portals

Microsoft Office

Job description

Care Options for Kids in Pennsylvania seeks a Lead, Revenue Cycle - Authorization Services to oversee a small team of Authorization Specialists and manage prior authorizations for in-home pediatric services across Medicaid, Medicare Advantage, and commercial payers. The role requires PA payer policy expertise, strong analytics, and a drive to reduce delays.

You will mentor staff, perform audits, and collaborate with Billing, Clinical Operations, and Branch Leadership to improve access and