Lead Prior Authorization Specialist
About The Position
Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today. Scheduled Weekly Hours: 40 Gundersen Health System is seeking a Lead Prior Authorization Specialist! In this role, you’ll help guide daily operations, support staff, and ensure patients receive timely and accurate authorizations for the services they need. If you enjoy problem‑solving, mentoring others, and working collaboratively across departments, this is a great opportunity to step into a role that makes a meaningful impact. What’s Available: FTE: 1.0 (40 hours weekly) Schedule: Monday-Friday, hours between 7 AM-4:30 PM Department: Prior Authorization Location: Onalaska This position is remote eligible after training Emplify Health is comprised of two of the Midwest’s most respected healthcare systems, Bellin Health and Gundersen Health System. Once neighbors, we are now partners, united in our mission to provide exceptional care to our communities. As a not-for-profit, patient-centered healthcare network, we have headquarters in Green Bay and La Crosse, Wisconsin. Our extensive network includes 11 hospitals and more than 100 clinics, serving 67 cities and rural communities across Wisconsin, Iowa, Minnesota and Michigan’s Upper Peninsula. With over 4,500 dedicated nurses and providers, we are committed to delivering primary, specialty and emergency care, along with innovative medical education programs. Join us in making a meaningful difference in the lives of our patients and communities. I f you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267. We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future. Equal Opportunity Employer
Requirements
- High school diploma or equivalent
- 3–5 years of healthcare experience with insurance and/or prior authorization
- One of the following certifications: Registered Health Information Technician (RHIT) Certified Professional Coder (CPC) Certified Coding Specialist (CCS)
Nice To Haves
- Previous experience processing prior authorizations preferred
- One year of leadership experience in healthcare desired
Responsibilities
- Provide LOVE + MEDICINE by supporting patients, staff, and clinical teams with clear, respectful communication
- Oversee daily work of Prior Authorization Specialists, ensuring accurate and efficient insurance verification and authorization processes
- Monitor productivity, quality, and adherence to payer rules, medical necessity requirements, and departmental standards
- Serve as a subject matter expert on insurance policies, coding requirements, and authorization processes
- Track and analyze authorization‑related denials and avoidable write‑offs, including Epic work queue management
- Collaborate with clinical departments to prepare patients for upcoming services
- Stay current on coding updates, payer policies, and regulatory requirements
Benefits
- Opportunities to grow your career with access to our Career Development Center and Tuition Investment Program
- Top‑rated retirement plan and healthcare benefits
- Supportive leadership that values your expertise and contributions
- Work/life balance so you can love what you do and where you live
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
