Senior Authorization Specialist - Pediatric RCM (Remote)

Care Options for Kids; Mount Laurel Township, Northern (NJ, KY); Hybrid; USD 45,000 - 55,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401K

Paid Time Off

Job summary

Care Options for Kids in Mount Laurel, NJ is seeking a Senior Associate, Authorization Services to join our revenue cycle team as a subject matter expert for complex credentialing and authorizations. The role emphasizes ownership, proactive problem-solving, and delivering exceptional service to internal and external stakeholders.

The position requires coordinating with providers, scheduling teams, payers, and patients to obtain timely authorizations, monitor status, and implement

Qualifications

• Minimum 3 years of experience in healthcare revenue cycle management, with a focus on billing, A/R, or authorizations.
• Experience with private duty nursing authorizations.
• Nevada and/or Florida Medicaid experience.
• High school diploma or GED required; associate or bachelor's degree preferred.
• Advanced proficiency with EMR systems, payer portals, and Microsoft Office tools.

Responsibilities

• Obtain and manage prior authorizations and pre-certifications for in-home nursing services.
• Verify insurance benefits and authorization requirements for Medicaid, managed Medicaid, commercial and federal plans.
• Submit complete authorization requests through payer portals, phone, or fax.
• Track authorization status and follow up to ensure timely approvals.
• Identify and escalate denials or delays for appeal or peer review.
• Maintain records of authorization activity in EMR systems.
• Stay current on payer policies, state and federal regulations.

Skills

Autonomous Ownership

Advanced Problem-Solving

Escalation Expertise

Customer-Centric Mindset

Process Improvement

Mentorship & Collaboration

Education

High school diploma or GED

Associate or Bachelor's degree preferred

Tools

EMR systems

Payer portals

Microsoft Office

Job description

Care Options for Kids in Mount Laurel, NJ is seeking a Senior Associate, Authorization Services to join our revenue cycle team as a subject matter expert for complex credentialing and authorizations. The role emphasizes ownership, proactive problem-solving, and delivering exceptional service to internal and external stakeholders.

The position requires coordinating with providers, scheduling teams, payers, and patients to obtain timely authorizations, monitor status, and implement