Manager of Prior Authorization
Listed on 2026-09-27
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Healthcare
Healthcare Administration, Healthcare Management
Position Summary
Under the general supervision of the Sr. Director of Revenue Cycle, the Manager of Prior Authorization oversees the authorization process for medical treatments, ensuring that required approvals are obtained from insurance providers. They manage a team that handles prior authorization requests, reviews policies to ensure compliance, and works to optimize approval process efficiency. This role involves collaboration with healthcare providers, insurance companies, and patients to minimize delays in care.
Strong leadership, knowledge of insurance guidelines, and experience in healthcare administration are essential for success in this position.
Under the general supervision of the Sr. Director of Revenue Cycle, the Manager of Prior Authorization oversees the authorization process for medical treatments, ensuring that required approvals are obtained from insurance providers. They manage a team that handles prior authorization requests, reviews policies to ensure compliance, and works to optimize approval process efficiency. This role involves collaboration with healthcare providers, insurance companies, and patients to minimize delays in care.
Strong leadership, knowledge of insurance guidelines, and experience in healthcare administration are essential for success in this position.
Required Qualifications
- Must be at least 18 years of age.
- Proof of highest level of education completed but not less than high school education or equivalent as recognized by an approved government accreditation association.
- Minimum of five (5) years of progressive, relevant experience and/or training required preferably in Physical Therapy, Hospice, Wound Care or Infusion
- Proven commitment to excelling in collections, dedication to company standards, and growth
- Verifies and reviews all prior authorization accordingly
- Ability to assess information, identify trends, and resolve issues
- Ability to lead and guide staff and work with ancillary departments
- Ability to sit for sustained periods of time.
- Ability to type with acceptable speed and accuracy
- Ability to effectively communicate in oral and written form.
- An understanding of computer systems, process design and data management.
- Must have a well-groomed, professional appearance.
- Must have the mental and physical ability to perform, with or without reasonable accommodation, the essential functions of the job.
- Ability to lift, carry, pull, & push 30 pounds.
- Language proficiency in English, with excellent written and verbal fluency.
- 3 to 5 years of computer experience or related education
- Knowledge of (but not limited to) Governmental Plans, Commercial, Medicare, HMO, PPO's, Third-Party Insurance Accounts, including but not limited to Medicaid, Managed Care, HMO, PPO, Auto and Work Comp rules and guidelines governing collection activities
- Previous supervisory or leadership experience
- Previous Meditech experience or other related electronic records system
Traci Johns
1600 S 20th Ave. Safford, AZ 85546
Email: tjohns
Phone:
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