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Director Insurance Prior Authorization Jobs (NOW HIRING)

Puget Sound Home Health

Prior Authorizations Specialist

$25 - $30/hr

Home Health & Hospice Prior Authorization Specialist$25-$30/hour | Full-Time | Remote Put Your Insurance Prior Authorization Expertise to Work From Home Puget Sound Home Health & Hospice is seeking ...

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Urology Centers of Alabama

Prior Authorization

Birmingham, AL · On-site

$16.75 - $22.50/hr

General Summary The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This ...

Urology Centers of Alabama

Prior Authorization

Homewood, AL · On-site

$18 - $24/hr

General Summary The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership ... Reliable transportation, driver's license and proof of auto insurance required. Background and ...

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Director Insurance Prior Authorization information

What does a director insurance prior authorization do?

A Director of Insurance Prior Authorization oversees the processes required to obtain insurance approvals for medical procedures, prescriptions, or treatments. They manage teams responsible for submitting prior authorization requests and ensure compliance with insurance guidelines and regulations. Their role includes improving workflow efficiency, reducing denials, and collaborating with healthcare providers and insurance companies. Additionally, they analyze trends to optimize the authorization process and provide training to staff on policy changes.

What are the key skills and qualifications needed to thrive as a director insurance prior authorization?

To thrive as a Director of Insurance Prior Authorization, you need expertise in healthcare administration, insurance processes, and regulatory compliance, typically supported by a bachelor's or master's degree in healthcare or business administration. Familiarity with prior authorization software, electronic health records (EHRs), and payer systems is crucial for overseeing efficient authorization workflows. Strong leadership, problem-solving, and communication skills help drive team performance and manage complex stakeholder relationships. These skills ensure timely approvals, reduce claim denials, and maintain regulatory compliance, which directly impact patient access and organizational revenue.

What are some common challenges faced by a director insurance prior authorization, and how can they be effectively managed?

A Director of Insurance Prior Authorization often encounters challenges such as navigating constantly changing insurance requirements, ensuring timely approvals for patient care, and managing high volumes of authorization requests. Effective management involves staying updated on payer policies, implementing robust tracking systems, and fostering strong communication between clinical, administrative, and payer teams. Building a knowledgeable team and utilizing technology to streamline workflows can also help reduce denials and improve turnaround times.

What is the difference between Director Insurance Prior Authorization vs Insurance Authorization Specialist?

AspectDirector Insurance Prior AuthorizationInsurance Authorization Specialist
CredentialsBachelor's degree, industry certifications often preferredHigh school diploma or equivalent, relevant certifications beneficial
Work EnvironmentManagement level, overseeing teams and processesOperational role, performing authorization tasks
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsMedical offices, insurance companies, healthcare providers
Primary ResponsibilitiesOverseeing authorization processes, policy compliance, team managementProcessing authorization requests, verifying coverage, documentation

The main difference is that the Director Insurance Prior Authorization manages teams and oversees authorization policies, while the Insurance Authorization Specialist handles the day-to-day processing of authorization requests. Both roles require knowledge of insurance policies, but the director position involves leadership and strategic oversight.

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Director Insurance Prior Authorization jobs near you
Infographic showing various Director Insurance Prior Authorization job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 87% In-person, 3% Hybrid, and 10% Remote job distribution.

Insurance Prior Authorization Representative

Resource Hub

Indianapolis, IN • On-site

$58K - $73K/yr

Full-time

Re-posted 6 days ago

Job description

Jumpstart your career at Rehab Medical, one of the nation's leading providers of custom advanced medical equipment and a recent Inc 5000 fastest growing U.S. company award winner! Based in Indianapolis, Indiana our company's mission is to improve and positively impact the lives of the patients we serve, the partners we engage with, and the employees we invest in.
We hire based on attitude, aptitude, and a drive to succeed, qualities that have awarded us one of Indiana's top places to work. Recently, we've experienced exponential growth so we're looking to expand our dynamic Insurance Team to support this growth and help us to improve the lives of more than 200,000 mobility users.
If you're looking for a rewarding opportunity where you can work alongside other dedicated individuals who will inspire you to grow your skill sets and advance your career, bring your passion and experience to Rehab Medical!
Why You Should Apply:
  • Guided Orientation Process at our Headquarters
  • Mentorship Onboarding Program
  • Employee Recognition Program
  • Leadership Development Program
  • Continuing Education Opportunities
  • Network of Support (health and well-being)

For prompt communication, we encourage applicants to opt into texting during the application process.
The Position: We are looking for an Insurance Prior Authorization Submission Representative to join our team!
Education and Experience:
  • High School Diploma
  • Prior Authorization experience highly preferred

Overview:
This position is responsible for verifying and reviewing Insurance orders and clinical documentation to ensure compliance with Insurance criteria and guidelines. Below are some key functions and skills for this opportunity:
  • Reviews clinical documentation from physical therapists and physicians to ensure compliance with insurance guidelines
  • Stays abreast of changing industry guidelines regarding Insurance
  • Pre-reviews evaluations for sales team
  • Records approvals and denials from insurance for trending
  • Responds to email and phone calls within 24 hours
  • Completes orders within 24 hours of entering queue
  • Communicates with sales team and other departments for accuracy
  • Submits authorization request to insurance; reviews quotes, documents, checks medical necessity qualifications
  • Achieves results expectations
    • Produces quality work, meeting the departmental guidelines and metrics
  • Other duties as assigned

We do not accept unsolicited resumes from outside recruiters/placement agencies. Rehab Medical will not pay fees associated with resumes presented through unsolicited means.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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