Senior Pediatric Revenue Cycle Lead - Authorization

Care Options for Kids; Pittsburgh (Allegheny County); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Generous Paid Time Off

401K

Job summary

Care Options for Kids is seeking a Lead, Revenue Cycle - Authorization Services to oversee a high-skill authorization team serving paediatric care programs. The role requires deep knowledge of PA payer requirements, including Medicaid MCOs and Medicare Advantage, and advanced EMR and payer portal usage.

You will drive improvements in authorization workflows, ensure timely approvals, and partner with clinical and billing teams to optimize revenue cycle performance while maintaining audit-ready

Qualifications

• Experience leading a small Authorization team.
• Expertise with PA payer requirements including Medicaid MCOs and Medicare Advantage.
• Strong knowledge of EMR systems and payer portals.

Responsibilities

• Serve as SME for authorization services, overseeing a designated payer group and leading a team of Authorization Specialists.
• Obtain prior authorizations, pre-certifications, and continued stay approvals for in-home healthcare and pediatric services.
• Monitor authorization status and drive timely resolutions to prevent delays in care and reimbursement.
• Analyze authorization trends and payer performance data to identify root causes and implement improvements.
• Maintain accurate documentation of authorization activity in EMR systems and revenue cycle platforms.

Skills

Authorization leadership

Team leadership

EMR systems

Payer portals

Data analytics

Tools

EMR systems

Payer portals

Microsoft Office

Reporting platforms

Workflow tools

Job description

Care Options for Kids is seeking a Lead, Revenue Cycle - Authorization Services to oversee a high-skill authorization team serving paediatric care programs. The role requires deep knowledge of PA payer requirements, including Medicaid MCOs and Medicare Advantage, and advanced EMR and payer portal usage.

You will drive improvements in authorization workflows, ensure timely approvals, and partner with clinical and billing teams to optimize revenue cycle performance while maintaining audit-ready