Revenue Cycle & Authorization Specialist

To The Rescue • Cedar Rapids, IA

10d

About The Position

To The Rescue is hiring a Revenue Cycle & Authorizations Specialist to support billing, claims, and service authorizations for our home health and human services programs. If you have experience with healthcare billing, Medicaid programs, or service authorizations and enjoy working behind the scenes to keep services running smoothly, this role offers a stable, weekday schedule and the opportunity to make a real impact.

Reporting to the Controller, you’ll work with program teams, clinical staff, and payers to help ensure services are authorized correctly, claims are submitted accurately, and reimbursements are received on time. Training and support are provided, and you’ll join a collaborative, mission-driven organization serving the community.

Requirements

• Experience or familiarity with healthcare billing, revenue cycle, authorizations, or Medicaid-funded human services
• Working knowledge of Medicaid billing, HCBS waivers, or other publicly funded programs, including payer rules and documentation requirements
• Comfort communicating with state agencies, managed care organizations, or payers regarding claims and authorizations
• Ability to reconcile authorizations, billed services, and supporting documentation to ensure accuracy and compliance
• Strong attention to detail and ability to manage multiple deadlines and follow-up activities
• Experience using EHRs, billing systems, case management systems, or authorization tracking tools
• Ability to work collaboratively across finance, clinical, and program teams

Nice To Haves

• 2+ years of experience in healthcare revenue cycle or Medicaid-funded human services
• Experience with denial management and accounts receivable follow-up
• Understanding of how authorization accuracy impacts reimbursement and revenue integrity

Responsibilities

• Prepare, review, and submit claims to Medicare, Medicaid, managed care organizations (MCOs), and commercial payers
• Ensure billed services align with approved authorizations, physician orders, and clinical documentation
• Submit RAPs (if applicable), final claims, corrected claims, and adjustments
• Monitor claim status and follow up on unpaid, rejected, or denied claims
• Maintain accurate billing records, notes, and payer correspondence
• Research and resolve claim denials and rejections
• Collaborate with clinical, intake, and authorization teams to correct issues and resubmit claims
• Support accounts receivable follow-up efforts to reduce aging and improve cash flow
• Communicate with payers regarding claim status, billing questions, and documentation needs
• Stay informed of payer updates and communicate changes that impact billing workflows
• Manage initial and ongoing service authorizations for Medicaid and publicly funded programs, including HCBS waivers.
• Monitor authorization limits, approved units, expiration dates, and service changes to prevent service gaps or denials
• Oversee reauthorizations, amendments, and retroactive approvals as needed
• Identify and help resolve utilization issues that may impact services or reimbursement
• Collaborate with program, clinical, and billing teams to align services, documentation, and funding
• Act as a key point of contact with state agencies, MCOs, CMAs, and other payers regarding authorization-related questions or issues
• Prepare and share internal reports related to authorization status, compliance risks, and revenue impact with leadership

Benefits

• Full-time, weekday schedule – predictable hours that support work-life balance
• Training and onboarding – we provide the support you need to succeed
• Collaborative, mission-driven environment – work with a team committed to helping vulnerable populations
• Opportunities for growth – develop your skills and advance in healthcare revenue cycle and human services operations

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed