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Director Insurance Prior Authorization Jobs in Wisconsin

Novir

Insurance Verification Representative

Milwaukee, WI

$16.75 - $21.50/hr

Be direct and open. Speak with honesty and courage, and respect others for doing the same. Say what ... prior authorization tasks. This role is critical in creating a smooth patient experience and ...

Regeneron Pharmaceuticals, Inc

WI · On-site

$183.10 - $305.20/hr

... prior authorization barriers. * Coordinate with specialty pharmacy partners and Patient Services ... insurance benefits (medical, dental, vision, life and disability), paid time off, and family ...

Regeneron Pharmaceuticals, Inc

WI · On-site

$183.10 - $305.20/hr

Partner with Market Access National and Payer Account Directors to align institutional contracting with broader payer strategy and resolve prior authorization barriers. * Coordinate with specialty ...

Actalent

Certified Pharmacy Technician

Milwaukee, WI · On-site

$17.75 - $21.75/hr

... prior authorization requests and making coverage determinations for a pharmacy services department within a large health insurance organization. You will evaluate requests for a wide range of ...

New

Neuroscience Group

Patient Access Team Lead

Appleton, WI · On-site

$23 - $28/hr

Team Lead - Patient Access Scheduling | Intake | Physical Therapy Intake & Prior Authorization Are ... Medical Insurance * Dental Insurance * Vision Insurance * Health Savings Account with generous ...

AssuranceSD

Authorization Specialist

Prairie Du Chien, WI · On-site

$16.75 - $22.25/hr

Through facilitating self-directed home and community-based services, AssuranceSD improves the ... Vision insurance * 401(k) with Company match * Life insurance * Long- and Short-Term Disability ...

New

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All JobsInsurance Prior Authorization JobsDirector Insurance Prior Authorization JobsDirector Insurance Prior Authorization Jobs in Wisconsin

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 Wisconsin?

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

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

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

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

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

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

Cities in Wisconsin 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 Wisconsin as of August 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 90% In-person, 2% Hybrid, and 8% Remote job distribution.

Insurance Verification Representative

Novir

Milwaukee, WI

$16.75 - $21.50/hr

Full-time

Re-posted 25 days ago

Job description

 Who We Are  
Novir is an emerging diagnostic biotechnology company with an unmatched team of professionals and trusted partners delivering smart, fast and flexible testing solutions supported by reliable, cost-effective screening products and best-in-class technology. 

Our Values  
Care for Tomorrow. Create a lasting, positive difference in the lives of others. Serve people with compassion and understanding. Recognize what truly matters and center every action around meeting the needs of our community both now and into the future. 
Delight our Customers. Appreciate every interaction with our customers and find ways to bring them joy. See through the Customer's eyes, understand and anticipate their needs to consistently deliver solutions exceeding their expectations. 
Be Bold - Say It. Be direct and open. Speak with honesty and courage, and respect others for doing the same. Say what you think, embrace passionate debate, and always bring the issue to the table. Communicate with confidence. 
Bring Your Best Self. Show up and be authentic. Utilize your greatest strengths and stay true to who you are. Bring positive energy, be genuine in your approach, and continually seek ways to grow. Be uncompromisingly you. 
Innovate Relentlessly. Explore new possibilities and be willing to take a risk. Challenge status quo. Try new ideas, learn from mistakes, and rally the team to raise the bar. 
 




The Insurance Verification Representative (Registration Representative) supports the patient intake and billing processes by ensuring accurate and complete registration, referral management, insurance verification, and prior authorization tasks. This role is critical in creating a smooth patient experience and supporting clean billing submissions for vaccination and diagnostic services. You will work in a team environment, updating patient data, verifying insurance, and assisting with medical claim follow-ups.

This is a seasonal role from August through January.  This is an onsite role with work hours possible from 7 am to 6 pm Monday through Friday.   Occasional weekend opportunities to work may be available.

 
What You'll Do:
  • Complete accurate registration and insurance verification for new and returning patients.
  • Ensure all patient demographic and payer data is correct and up-to-date.
  • Assist with referral management and prior authorizations as needed.
  • Support medical billing efforts by screening and updating payer data to ensure clean claims.
  • Follow up on unpaid or denied claims and assist in preparing insurance appeals.
  • Maintain detailed documentation in systems to support billing and compliance workflows.
  • Assist in resolving billing issues related to vaccination services.
  • Monitor and clear assigned work queues, reports, and pending authorizations.
  • Comply with HIPAA and confidentiality standards at all times.
Key Experience We Are Looking For:
  • High school diploma or equivalent.
  • Prior customer service experience, preferably in a healthcare setting.
  • Working knowledge of registration and insurance verification.
  • Clear, professional written and verbal communication skills.
  • Proficiency in Microsoft Office Suite and basic data entry/typing skills.
  • Strong attention to detail, organization, and time management.
  • Ability to work independently and in a team.
  • Ability to maintain patient confidentiality and professionalism in all interactions.
Preferred Experience:
  • 1 year of experience in healthcare office setting, performing registration, insurance verification, or billing.
  • Familiarity with medical terminology, insurance processes, and payer systems (e.g., Medicaid, Medicare).
  • Experience working with CPT, ICD-10, HCPCS codes.
  • Prior experience using Epic or other EHR/billing systems.
  • Certificate in Medical Billing and Coding (CCA) or related credential is highly desirable.
  • Familiarity with vaccination billing and reimbursement guidelines.
Who You Are:
  • Detail-Oriented: You ensure accuracy in all data entry and billing support functions.
  • Curious: You ask questions, seek to understand and continuously learn.
  • Dependable: You show up on time, meet deadlines, and complete tasks fully.
  • Collaborative Communicator: You communicate clearly and respectfully with team members and patients.
  • Patient-Focused: You care deeply about creating a positive patient experience.
  • Adaptable: You're comfortable working in a fast-paced, ever-evolving environment.
Why Join Novir?
  • Be part of a mission-driven team creating a real impact in healthcare.
  • Join a startup culture with opportunities for growth, flexibility, and innovation.
  • Work with smart, passionate professionals in a values-led environment.

Please submit your resume. Interviews will only be scheduled for candidates with relevant medical billing experience or a valid certificate in Medical Billing and Coding.

Novir is a fast-growing startup with a work hard, play hard attitude. We look for smart, motivated individuals who are excited to build something incredible from the ground up! 
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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