Senior Pediatric Revenue & Authorization Lead

UCSF Health, AG; Emeryville (CA); On-site; USD 120,000 - 150,000; Full time

Job summary

UCSF Health in Emeryville, CA is seeking a Pediatric Lead Revenue Analyst who independently manages complex authorization with expert knowledge of CCS and Medicaid guidelines. You will supervise a team, coordinate prior authorizations, review medical documentation, and drive optimized reimbursements for high-cost pediatric care across inpatient, NICU, and outpatient services.

The role requires strong analytical and communication skills and a track record of improving denial rates while ensuring

Qualifications

• Knowledge of healthcare eligibility and insurance verification processes.
• Understanding hospital and outpatient clinic registration, referral, authorization, and billing processes.
• Strong customer service and interpersonal communication skills.
• Experience with Medi-Cal and other California public healthcare programs.
• Experience working with pediatric patients and their families.
• Experience with electronic health records and hospital registration or revenue‑cycle systems.
• Knowledge of pediatric authorization requirements and processes, with experience navigating diverse insurance plans.

Responsibilities

• Lead workflow distribution and quality assurance for ~10 authorization staff.
• Coordinate prior authorizations across commercial and government payers.
• Oversee option to secure authorizations and resolve denials.
• Analyze denial trends and workflow to improve efficiency and access.
• Collaborate with clinical, administrative, and billing teams to ensure timely processing.

Skills

Healthcare eligibility

Insurance verification

Hospital registration and billing

Customer service

Pediatrics payer coordination

Electronic health records

Prior authorizations

Education

High School diploma or GED

Bachelor's degree

Job description

UCSF Health in Emeryville, CA is seeking a Pediatric Lead Revenue Analyst who independently manages complex authorization with expert knowledge of CCS and Medicaid guidelines. You will supervise a team, coordinate prior authorizations, review medical documentation, and drive optimized reimbursements for high-cost pediatric care across inpatient, NICU, and outpatient services.

The role requires strong analytical and communication skills and a track record of improving denial rates while ensuring