... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
Medication Access Specialist
Middleton, WI · On-site
$22.40 - $33.60/hr
... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
Medication Access Specialist
Middleton, WI · On-site
$22.40 - $33.60/hr
... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
... insurance related field Required * 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred * 2 years of experience in preadmission/precertification Preferred
Field Reimbursement Manager
Madison, WI · On-site
$100 - $125/hr
Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or clinics. * Must have Medicare and ...
Field Reimbursement Manager
Madison, WI · On-site
$100 - $125/hr
Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or clinics. * Must have Medicare and ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Pharmacy Technician Specialist - Specialty Pharmacy
Middleton, WI · On-site
$18 - $21.75/hr
... prior authorizations. * Help support our pharmacy services across the entire Madison area. * Be a ... An excellent benefits package, including health and dental insurance, paid time off, retirement ...
Community Support Program - Registered Nurse
Janesville, WI · On-site
$40.28 - $43.85/hr
... insurance, prior authorizations, prescription refills, assistance with informed consents for ... Direct deposit is a requirement of employment. * Holidays (Ordinance 18.501): The following ...
Community Support Program - Registered Nurse
Janesville, WI · On-site
$40.28 - $43.85/hr
... insurance, prior authorizations, prescription refills, assistance with informed consents for ... Direct deposit is a requirement of employment. * Holidays (Ordinance 18.501): The following ...
Community Support Program - Registered Nurse
Janesville, WI · On-site
$40.28 - $43.85/hr
... clients, insurance, prior authorizations, prescription refills, assistance with informed consents for medications 5% Other duties as assigned Success Factors (KSA's) Knowledge of the current ...
Community Support Program - Registered Nurse
Janesville, WI · On-site
$40.28 - $43.85/hr
... clients, insurance, prior authorizations, prescription refills, assistance with informed consents for medications 5% Other duties as assigned Success Factors (KSA's) Knowledge of the current ...
Direct Primary Care Physician - Madison, WI
Madison, WI · On-site
$300K/yr
... insurance companies for prior authorizations, this is the antidote. What Makes This Different ... Direct Primary Care means no billing headaches, no prior-auth battles, and none of the ...
Direct Primary Care Physician - Madison, WI
Madison, WI · On-site
$300K/yr
... insurance companies for prior authorizations, this is the antidote. What Makes This Different ... Direct Primary Care means no billing headaches, no prior-auth battles, and none of the ...
Medigap Helpline Services Director - Career Executive
Madison, WI · On-site
$45.35 - $48.95/hr
... authorized, independent Medicare insurance counseling programs operating as part of the State ... Evidence of auto insurance must be obtained prior to the selected candidate's start date if using a ...
Medigap Helpline Services Director - Career Executive
Madison, WI · On-site
$45.35 - $48.95/hr
... authorized, independent Medicare insurance counseling programs operating as part of the State ... Evidence of auto insurance must be obtained prior to the selected candidate's start date if using a ...
Registration Specialist - Therapy & Wellness Center
Dodgeville, WI · On-site
$17 - $22.50/hr
Other duties as requested by Therapy Center Director. * Some prior authorization work may be required. Qualifications: * Health care professional certification or other demonstrated health care ...
Registration Specialist - Therapy & Wellness Center
Dodgeville, WI · On-site
$17 - $22.50/hr
Other duties as requested by Therapy Center Director. * Some prior authorization work may be required. Qualifications: * Health care professional certification or other demonstrated health care ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Patient Service Representative - Perinatal Clinic; 0.8 FTE; Day Shift
Madison, WI · On-site
$17.75 - $22.50/hr
... patient prior authorization, registration and scheduling. They greet and register patients on ... Dental, health and vision insurance, paid holidays, short and long-term disability and more. We ...
Clinic Registered Nurse
Janesville, WI · On-site
$80 - $100/hr
Patient referral process: schedules tests/procedures as directed, contacts insurance company to obtain prior authorization. Documents telephone encounters, capturing pertinent data and notifies ...
Clinic Registered Nurse
Janesville, WI · On-site
$80 - $100/hr
Patient referral process: schedules tests/procedures as directed, contacts insurance company to obtain prior authorization. Documents telephone encounters, capturing pertinent data and notifies ...
Direct Primary Care Physician - Madison, WI
Madison, WI · On-site
$250/hr
Direct Primary Care Physician - Madison, WI Kerix madison, Wisconsin, United States About this ... insurance companies for prior authorizations, this is the antidote. What Makes This Different
Direct Primary Care Physician - Madison, WI
Madison, WI · On-site
$250/hr
Direct Primary Care Physician - Madison, WI Kerix madison, Wisconsin, United States About this ... insurance companies for prior authorizations, this is the antidote. What Makes This Different
Admissions Director
Jefferson, WI · On-site
$80 - $100/hr
Admissions Director Location: Jefferson, Wisconsin Company: Alden Estates of Jefferson Job Type ... Initiating insurance authorizations, verifying benefits, and collecting payments from residents and ...
Admissions Director
Jefferson, WI · On-site
$80 - $100/hr
Admissions Director Location: Jefferson, Wisconsin Company: Alden Estates of Jefferson Job Type ... Initiating insurance authorizations, verifying benefits, and collecting payments from residents and ...
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?
| Aspect | Director Insurance Prior Authorization | Insurance Authorization Specialist |
|---|---|---|
| Credentials | Bachelor's degree, industry certifications often preferred | High school diploma or equivalent, relevant certifications beneficial |
| Work Environment | Management level, overseeing teams and processes | Operational role, performing authorization tasks |
| Employer & Industry Usage | Hospitals, insurance companies, healthcare organizations | Medical offices, insurance companies, healthcare providers |
| Primary Responsibilities | Overseeing authorization processes, policy compliance, team management | Processing 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 popular job titles related to Director Insurance Prior Authorization jobs in Madison, WI?
For Director Insurance Prior Authorization jobs in Madison, WI, the most frequently searched job titles are:
What job categories do people searching Director Insurance Prior Authorization jobs in Madison, WI look for?
The top searched job categories for Director Insurance Prior Authorization jobs in Madison, WI are:
Other
Medical, Dental, Retirement, PTO
Posted 13 days ago
UW Health rating
7.9
Based on 227 frontline employees who took The Breakroom Quiz
111th of 898 rated healthcare providers
Job description
Work Schedule:
1.0FTE. Monday - Friday. Hours vary 8:00AM - 6:00PM. Hours may vary based on the needs of the department. This is a hybrid position. When working on site, you will work at the Pharmacy Services Building in Middleton, WI.
Be part of something remarkable
Join the #1 hospital in Wisconsin!
We are seeking a Medication Access Specialist to:
- Collaborate with providers, pharmacists, and clinic staff to resolve complex insurance issues for patients.
- Deliver excellent customer service to both internal and external customers.
- Foster strong teamwork and collaboration within the department.
- Enjoy a great schedule with no weekends or holidays.
At UW Health, you will have:
- An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance.
- Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance.
- Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and physical well-being.
- Tuition benefits eligibility - UW Health invests in your professional growth by helping pay for coursework associated with career advancement.
Qualifications
- No minimum education Required
- Associate's Degree in Health Science, Business or a related field Preferred
Work Experience
- 1 year of experience in a healthcare, business, finance, or insurance related field Required
- 2 years of experience in Healthcare Revenue Cycle that includes prior authorization Preferred
- 2 years of experience in preadmission/precertification Preferred
- Knowledge of CPT and ICD coding highly desired Preferred
- Knowledge of Medicare and third-party payer regulations and guidelines highly desired Preferred
Licenses & Certifications
- Wisconsin Pharmacy Technician Registration Upon Hire Required
- Licensed Practical Nurse (LPN) or Certified Pharmacy Technician (CPhT) Preferred
Our Commitment to Social Impact and Belonging
UW Health is committed to fostering a workplace that creates belonging for everyone and is an Equal Employment Opportunity (EEO) employer. Our respect for people shines through patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. It is the policy of UW Health to provide equal opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
UW Health Pharmacy Services Building - a non-clinical location in Middleton that houses nearly 100 Pharmacy professionals. These employees perform various services and duties, including pharmacy administration, Pharmacy Technician Training Program, pharmacy primary care services, medication prior authorization, sterile and non-sterile compounding, specialty/mail service program and call center.
Job Description
UW Hospital and Clinics benefits
What UW Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About UW Health
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UW Health Clinics - our physicians and staff are dedicated to providing an exceptional patient and family experience by delivering the highest quality of care in a compassionate environment. With more than 80 primary and specialty care clinics located throughout Dane County and the surrounding areas, we are proud to have the opportunity to impact the communities we serve.
Industry
Health care and social assistance and hospitals
Company size
10,000+ Employees
Headquarters location
Madison, WI, US