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Director Insurance Prior Authorization Jobs (NOW HIRING)

DRH Health

Authorization Specialist

Duncan, OK · On-site

$17.25 - $23/hr

Provides prior authorization of all CS procedures to ensure coverage for claim payment. * Makes direct contact with physicians/providers, nurses, and patients as well as insurance companies and their ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... Ensure adherence to all regulatory and privacy requirements, including the Health Insurance ...

Aquent

Prior Authorization Specialist

Palo Alto, CA · On-site

$35.81 - $38.96/hr

Conduct timely outreach via phone to pharmacy benefit managers (insurers), pharmacies, and patients to gather necessary information, resolve issues, and communicate prior authorization status.

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Director Insurance Prior Authorization information

What does a Director of 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 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 key skills and qualifications needed to thrive as a Director of Insurance Prior Authorization, and why are they important?

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 of 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.
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Director Insurance Prior Authorization jobs near you
Infographic showing various Director Insurance Prior Authorization job openings in the United States as of May 2026, with employment types broken down into 96% Full Time, 3% Part Time, and 1% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Prior Authorization Coordinator

UBMD Internal Medicine

Amherst, NY • On-site

$20 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Job description

Company Description

UBMD Internal Medicine (UBMDIM) is the academic medical practice affiliated with the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. With 135 Primary and Specialty Care physicians supported by 187 staff members, UBMDIM operates across 16 hospital and outpatient clinic locations in the Buffalo-Niagara Falls area. As the largest practice plan in the UBMD Physicians' Group, UBMDIM integrates patient care, medical education, and research, playing a pivotal role in advancing healthcare in the region. The organization is dedicated to treating patients, teaching future healthcare professionals, and discovering innovative treatments for various diseases.

Role Description

This is a full-time on-site role based in Williamsville, NY for a Prior Authorization Coordinator. The role involves managing prior authorization requests for medical services, interacting with healthcare providers and insurance companies, and ensuring compliance with payer guidelines. The Coordinator will review patient files, submit prior authorization requests, track approvals or denials, and provide regular updates to clinical staff. Additional responsibilities include maintaining accurate documentation, addressing payment discrepancies, and serving as a liaison to streamline communication between patients, providers, and insurance organizations.

Qualifications
    1. Experience with prior authorization processes, healthcare insurance requirements, and payer guidelines.
    2. Strong organizational, time management, and problem-solving skills.
    3. Proficiency with medical terminology and clinical documentation.
    4. Effective written and verbal communication skills for interacting with patients, physicians, and insurance representatives.
    5. Familiarity with electronic health records (EHR) systems and basic computer skills.
    6. Attention to detail and the ability to handle sensitive patient information with confidentiality.
    7. Previous experience in a medical office, billing, or pre-certification role is an advantage.
    8. High school diploma or equivalent required; post-secondary education in a related field is preferred.
Benefits:

401(k)

401(k) matching

Dental insurance

Employee assistance program

Health insurance

Life insurance

Paid time off

Vision insurance

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