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Director Insurance Prior Authorization Jobs in Decatur, GA

Precertification Specialist

Smyrna, GA · On-site

$22/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services. * Verify patient insurance eligibility, benefits, coverage, and authorization requirements ...

Precertification Specialist

Smyrna, GA · On-site

$22/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services. * Verify patient insurance eligibility, benefits, coverage, and authorization requirements ...

Clinical Domain Project Manager (PBM)

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... prior authorization, utilization management, drug utilization review, clinical criteria ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...

Clinical Domain Project Manager (PBM)

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... prior authorization, utilization management, drug utilization review, clinical criteria ... Builds collaborative relationships with pharmacy directors, clinical pharmacists, business analysts ...

Revenue Cycle Manager

Alpharetta, GA · On-site

$150K - $156K/yr

  • Medical

  • Dental

  • Vision

The ideal Revenue Cycle Manager has multiple years of direct revenue cycle experience, holds a ... Prior Authorization, or Patient Financial Engagement * Hands-on Experience With Payer Contracting ...

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Lead medical assistant

Peachtree Corners, GA · On-site

$16 - $20.75/hr

  • Medical

  • Dental

  • Retirement

  • PTO

Start and follow up Prior Authorization * Change dressings * Clean and maintain instruments and ... Provide patient education as directed by the doctor or other provider * Remove staples and stitches

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Lead medical assistant

Peachtree Corners, GA · On-site

$16 - $20.75/hr

  • Medical

  • Dental

  • Retirement

  • PTO

Start and follow up Prior Authorization * Change dressings * Clean and maintain instruments and ... Provide patient education as directed by the doctor or other provider * Remove staples and stitches

Pharmacy Tech II-Bilingual

Atlanta, GA

$16.75 - $20.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Processes prior authorization requests from physician's offices and ensures compliance with ... insurance, wellness programs and financial education resources, to name a few. Elevance Health ...

Pharmacy Tech II-Bilingual

Atlanta, GA

$16.75 - $20.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Processes prior authorization requests from physician's offices and ensures compliance with ... insurance, wellness programs and financial education resources, to name a few. Elevance Health ...

Showing results 21-40

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 job categories do people searching Director Insurance Prior Authorization jobs in Decatur, GA look for?

The top searched job categories for Director Insurance Prior Authorization jobs in Decatur, GA are:

What cities near Decatur, GA are hiring for Director Insurance Prior Authorization jobs?

Cities near Decatur, GA with the most Director Insurance Prior Authorization job openings:

Insurance Verification Specialist - Procedure Scheduling Experience Preferred

ATLii & John C. Lipman

Smyrna, GA • On-site

$17 - $21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago


Job description

Our busy practice is growing and we have an immediate need for an Insurance Verification/Authorization Specialist. This position will be responsible for pre-procedure verification of benefits, obtaining authorizations, financial calculations, appeals, and working with the rest of the team to ensure that our patients have an exceptional experience.
We offer the right candidate a teamwork-oriented, friendly, and supportive working environment and we take great pride in our national reputation for excellence.
This position requires experience working in healthcare, particularly in surgical subspecialties. Experience in Interventional Radiology is not required, but is a Plus!
Applicant must have an understanding of scheduling templates, protocols, and requirements. This position will also complete pre-procedure insurance benefit verification and create accurate financial estimates for our patients. Patient financial counseling and making payment plan arrangements are also an important part of this job. This position is part of the business office team and can count on the support of their teammates to help them at every turn.
The right person will demonstrate:
  • Proven prior relevant experience including
    • Insurance Verification
    • Prior Authorization acquisition
    • Benefits Determination & Out-of-Pocket Calculation
    • *Procedure Scheduling experience a plus
  • Experience working directly with patients in person and via telephone/email
  • Frequent and thorough documentation- regarding the status of patients' cases
  • Excellent written & oral communication, time management skills
  • A strong desire to work collaboratively with colleagues to achieve a shared goal
  • A professional appearance and demeanor with both colleagues and patients
  • Enthusiasm and a desire to learn

Benefits Include
  • Competitive salary
  • No nights, weekends or holidays
  • Accrued Paid Time Off (PTO)
  • Paid holidays including the Friday after Thanksgiving and an annual "Floating Holiday."
  • Employer contributed health plan, dental, and vision plans
  • Employer-matching 401k retirement plan
  • A great group of colleagues to work with each day

Please click here for a link to our website http://www.ATLii.com to learn more about us and apply for this position
We are an equal opportunity employer and do not discriminate based on race, religion, age, national origin, gender, or sexual orientation