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Director Insurance Prior Authorization Jobs in Florida

South Florida Nephrology Consultants, PL

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Medical Assistant Nephrology

Pembroke Pines, FL · On-site

$16.50 - $21/hr

Manage appointment scheduling, prescription refills, and insurance/prior authorization processing * Answer clinic telephones and support front-desk operations * Provide patient education on self-care ...

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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.

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

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

What are popular job titles related to Director Insurance Prior Authorization jobs in Florida?

For Director Insurance Prior Authorization jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Director Insurance Prior Authorization jobs in Florida look for?

The top searched job categories for Director Insurance Prior Authorization jobs in Florida are:

What cities in Florida are hiring for Director Insurance Prior Authorization jobs?

Cities in Florida with the most Director Insurance Prior Authorization job openings:

Director Insurance Prior Authorization jobs near you
Infographic showing various Director Insurance Prior Authorization job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.

Referral and Prior Authorization Specialist

Suntree Internal Medicine Inc

Melbourne, FL • On-site

$15 - $16/hr

Full-time

Retirement, PTO

Re-posted 6 days ago

Job description

Position

Medical Referral and Prior Authorization Specialist

FLSA Status

Hourly Non-Exempt

Reports to

Documents Manager

Shift

8 hour shifts (varies)

Reporters

0

Lunch

30 minutes


Wage: $15.00- $16.00 per hour


Education: 

High School Diploma or GED required

Medical Terminology Knowledge required

Medical Experience preferred


Responsibilities:

  • Process referral requests made by providers.

  • Gather medication information: quantity, diagnosis, dosages, directions

  • Gather patients current insurance information

  • Ensure accuracy of forms and clinical questions per insurance company

  • Utilize the covermymeds system for medication prior authorizations and keeping the requests cleaned up.

  • Enter requests into the DASH system and compile referrals and records to be sent to the specialist office ensuring that the provider we send a patient to accepts the insurance the patient has..

  • Communicate with the patientsthe status of any referrals or prior authorizations sent on a patient’s behalf.

  • Obtain authorizations as required for patients to see specialists or procedures that they ordered as necessary.

  • Work on lab rebills as needed.

  • Transmit information or documents to customers, using a computer, mail, or facsimile machine.

  • Analyze data to determine answers to questions from patients.


Abilities:

  • High-level of multi-tasking

  • Time management skills

  • Medical Terminology

  • Team player

  • Follow step-by-step procedures

  • Personable



Physical Requirements:

  • Requires full range of body motion including handling and lifting of patients, manual and finger dexterity, and hand-eye coordination.

  • Requires standing and walking for extensive periods of time

  • Occasionally lifts and carries items weighing up to fifty (50) pounds

  • Requires corrected vision, hearing, and speech within normal ranges

  • Requires working under stressful conditions and sometimes irregular hours

  • Potential contact with bloodborne pathogens, bodily secretions, etc.


Background Screening Requirements

  • You must pass a level 2 background screening PRIOR to joining Suntree Internal Medicine.   If you have have one done and do not have one on file, after 90 days of employment Suntree Internal Medicine will reimburse you for this up to $85.00.  Please provide your receipt to HR on your first day. 


About Suntree Internal Medicine:

We are a large private internal medicine practice located in Melbourne, Florida. We are an equal opportunity employer and we believe that education and training are a key part of success. Our values are to bring Sincerity, Inspiration, and Mastery into the workplace. We offer benefits, paid time off, 401K and holidays after the 90-day probation period review. 






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