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Director Prior Authorization Jobs (NOW HIRING)

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

... direct supervision. * Tech-Savvy and Detail-Oriented - Proficiency in Electronic Health Records ... Experience with prior authorizations for biologics, oncology, or specialty therapies preferred. Why ...

BrightSpring

Prior Authorization Specialist

Louisville, KY · On-site

$16.50 - $22/hr

Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of ... prior authorization is being followed up on * Assists Billing Department with resolving unbilled ...

Independent Health Association

$22/hr

May also include transcribing Medical Director decision into systems. * As volume dictates, timely ... Fax prior authorization requests including requests for additional information and completed ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of ... prior authorization is being followed up on * Assists Billing Department with resolving unbilled ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of ... prior authorization is being followed up on * Assists Billing Department with resolving unbilled ...

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Director Prior Authorization information

What is the difference between Director Prior Authorization vs Medical Claims Supervisor?

AspectDirector Prior AuthorizationMedical Claims Supervisor
Required CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentHealthcare organizations, insurance companiesHealthcare providers, insurance companies
Employer & Industry UsageUsed in health insurance and healthcare managementCommon in healthcare administration and insurance claims processing
Primary FocusReviewing and approving prior authorization requestsOverseeing claims processing and ensuring accuracy

The main difference is that the Director Prior Authorization focuses on managing the approval process for medical procedures before they occur, while the Medical Claims Supervisor oversees the processing and accuracy of claims after services are provided. Both roles require healthcare knowledge, but their responsibilities and workflows differ significantly.

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Prior Authorization Specialist

Willis Knighton Health

Shreveport, LA • On-site

$17.25 - $23/hr

Full-time

Re-posted 5 days ago

Job description

The Willis Knighton Department of Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our team.  This individual will work directly with our Outpatient Infusion Units under the supervision of the Pharmacy Director and act as a liaison between patients, healthcare providers, and insurance companies to ensure timely patient care and compliance with payer requirements.  A high school diploma is required, and a basic knowledge of medical terminology, medical billing, and familiarity with computers and Microsoft Office products is preferred.  The Prior Authorization Specialist will review medication orders to determine if medications require prior authorization, verify insurance coverage, and work closely with healthcare providers to collect necessary clinical information.  Great attention to detail is a necessary quality.  The shift hours will be 8-hour days.  If you are interested, please apply for this position.

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