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Director Insurance Prior Authorization Jobs in Madison, WI

SSM Health

Rehabilitation Services Aide

Madison, WI · On-site

Under direct supervision of a physical or occupational therapist, assists in providing patient care, including assistance with insurance prior authorization. Takes responsibility for equipment ...

State of Wisconsin

Insurance Accounting Director

Madison, WI · On-site +1

$101K - $113K/yr

The Insurance Accounting Bureau is seeking a Director to oversee fiscal operations for multiple ... Prior to any appointments for position(s) filled from this announcement, candidates may be subject ...

New

Pharmacy Careers

Formulary Management Pharmacist

Madison, WI · On-site

$58.75 - $70.50/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy ... About Us We are a confidential healthcare organization working with PBMs, insurers, and health ...

The Alden Network

Admissions Director

Jefferson, WI · On-site

$70K/yr

) Admissions Director Location: Jefferson, Wisconsin Company: Alden Estates of Jefferson Job Type ... Initiating insurance authorizations, verifying benefits, and collecting payments from residents and ...

Kerix

Family Practice - Without OB Physician

Madison, WI · On-site

$300K/yr

... for prior authorizations, this is the antidote. What Makes This Different * Hour-long patient ... No insurance hassles. Direct Primary Care means no billing headaches, no prior-auth battles, and ...

State of Wisconsin

Communications Director

Madison, WI · On-site

$77K - $117K/yr

How To Apply We are seeking candidates who are legally authorized to work in the United States and ... A background check will be conducted on all finalists prior to an offer of employment. Applications ...

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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 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:

Director Insurance Prior Authorization jobs near you
Infographic showing various Director Insurance Prior Authorization job openings in Madison, WI as of August 2026, with employment types broken down into 83% Full Time, 14% Part Time, and 3% Contract. Highlights an 90% In-person, 2% Hybrid, and 8% Remote job distribution.

Rehabilitation Services Aide

SSM Health

Madison, WI • On-site

Full-time

Re-posted 22 days ago

SSM Health rating

6.8

Company rating: 6.8 out of 10

Based on 550 frontline employees who took The Breakroom Quiz

500th of 893 rated healthcare providers

Job description

It's more than a career, it's a calling.
WI-SSM Health Dean Medical Group South Madison Campus
Worker Type:
Regular
Job Summary:
Under direct supervision of a physical or occupational therapist, assists in providing patient care, including assistance with insurance prior authorization. Takes responsibility for equipment maintenance and supply inventory for the therapy services department. Travel among sites is required.
Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
  • Rooms patients, takes vitals and prepares patient for treatment.
  • Provides direct care to patients as directed and supervised by a therapist.
  • Recognizes and acts when patient care requires intervention by a therapist.
  • Maintains clean and safe conditions for patient care areas and equipment. Monitors equipment function. Performs and records required equipment calibration tasks.
  • Documents and communicates using the electronic health record including: insurance prior authorizations; patient calls and communications.
  • Works in a constant state of alertness and safe manner.
  • Performs other duties as assigned.

EDUCATION
  • High School diploma/GED or 10 years of work experience

EXPERIENCE
  • No experience required

PHYSICAL REQUIREMENTS
  • Constant standing and walking.
  • Frequent use of hearing and speech to share information through oral communication.
  • Frequent use of hearing to distinguish body sounds and/or hear alarms, malfunctioning machinery, etc.
  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
  • Frequent reaching, gripping, and keyboard use/data entry.
  • Frequent use of vision for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
  • Occasional bending, stooping, crawling, kneeling, sitting, squatting and repetitive foot/leg and hand/arm movements.
  • Occasional use of vision to judge distances and spatial relationships.
  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
  • Occasional lifting/moving patients.
  • Occasional use of smell to detect/recognize odors.
  • Occasional driving.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
Resuscitation Certification Requirement: Basic Life Support Healthcare Provider (BLS HCP) required within 90 day of employment. Other resuscitation certifications may be required dependent on department.
Work Shift:
Day Shift (United States of America)
Job Type:
Employee
Department:
5240010164 SMC PT
Scheduled Weekly Hours:
40
Benefits:
SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
  • Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
  • Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
  • Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.

Explore All Benefits
SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity,pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

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