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Contract Insurance Prior Authorization Jobs in Wisconsin

Southwest Health

Referral Advocate

Platteville, WI · On-site

$17.25 - $22.50/hr

Performs prior authorization on all High-End Radiology, Referrals, and surgeries indicated by a physician order. * Assists Patient Financial Services department to insure prior authorization ...

Advocate Aurora Health

HTM Contract Manager

Burlington, WI · Remote

$47.50 - $71.25/hr

Develops and publishes all communication on assigned HTM contracts, related email communications, reference tools, product and rate summaries, prior authorization requirements and other contract ...

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Contract Insurance Prior Authorization information

What is the difference between Contract Insurance Prior Authorization vs Medical Insurance Claims Specialist?

AspectContract Insurance Prior AuthorizationMedical Insurance Claims Specialist
Primary RoleSecuring approval for specific procedures or treatments before serviceProcessing and managing insurance claims after services are rendered
Work EnvironmentHealthcare providers, insurance companies, or third-party administratorsHospitals, clinics, insurance companies, or claims processing centers
Required CredentialsKnowledge of insurance policies, healthcare regulations, often certifications in healthcare administrationUnderstanding of insurance billing, coding, and claims processing, often with certifications like CPC or CCS

Contract Insurance Prior Authorization involves obtaining approval before healthcare services, while Medical Insurance Claims Specialists handle post-service claims processing. Both roles require knowledge of insurance policies and healthcare regulations, but they focus on different stages of the insurance process.

What are the most commonly searched types of Insurance Prior Authorization jobs in Wisconsin?

The most popular types of Insurance Prior Authorization jobs in Wisconsin are:

What are popular job titles related to Contract Insurance Prior Authorization jobs in Wisconsin?

For Contract Insurance Prior Authorization jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Contract Insurance Prior Authorization jobs in Wisconsin look for?

The top searched job categories for Contract Insurance Prior Authorization jobs in Wisconsin are:

What cities in Wisconsin are hiring for Contract Insurance Prior Authorization jobs?

Cities in Wisconsin with the most Contract Insurance Prior Authorization job openings:

Contract Insurance Prior Authorization jobs near you
Infographic showing various Contract Insurance Prior Authorization job openings in Wisconsin as of July 2026, with employment types broken down into 1% As Needed, 84% Full Time, 12% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Prior Authorization Assistant

Integrated Resources INC

Milwaukee, WI

$18 - $23.50/hr

Contractor

Re-posted 4 days ago

Job description

Job Description

Duration: 3 to 6 months

Medicaid/Medicare background preferred but not required.

Job Description

Nature of Work:

This position provides assistance to the Prior Authorization Department. This position reports to the Prior Authorization Manager.

Duties and Responsibilities:

  • Duties listed below may vary in terms of importance and other duties may be added or eliminated as this position develops.
  • Essential Duties and Responsibilities:
  • Process and documents all incoming inpatient and outpatient prior authorization (PA) requests as outlined by Client policies and procedures.
  • Contacts providers via phone or fax to request additional information or clarification as needed per established process.
  • Communicates effectively with customers/providers (both internally and externally) regarding the status of PA requests.
  • Enters PA requests into the prior authorization database , prepares documentation, and tasks to the appropriate staff member for clinical review.
  • Completes special projects as requested.

Marginal Functions:

Required Qualifications:

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
  • A combination of education, training and experience which provides the necessary knowledge, skills, and abilities as listed below will be considered:
  • Ability to communicate effectively both verbally and in writing.
  • Knowledge of general business practices
  • Detail oriented and organized work ethic.
  • Ability to work independently as well as in a team environment.
  • Ability to use a personal computer and Microsoft Office software applications, including Word and Excel.
  • Knowledge of appropriate telephone etiquette and general business practices

Desirable Qualifications:

  • Previous experience in a clinical environment.
  • Previous experience working in managed health care setting or insurance environment.
  • Knowledge of Medical Terminology.
  • Knowledge of additional Microsoft Office software such as PowerPoint.

Physical Demands:

  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
  • Must be able to communicate with members, providers, and staff in an effective manner via the telephone and in person.
  • Must be able to communicate in writing and understand written materials of a complicated manner.
  • Must be able to use a computer terminal to input and access information in a timely manner.
  • Must be able to work in a fast-paced environment.
  • More than 50% of the time, employee will be working at a desk, with a PC terminal.

Work Conditions/Environment:

Additional Information

All your information will be kept confidential according to EEO guidelines.

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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