ZipRecruiter

Log In

2

Full Time Prior Authorization Rn Jobs in Florida

Palm Beach Nursing

Registered Nurse (RN)

Lake Worth, FL · On-site

$40/hr

Lake Worth, FL Schedule: Full-Time | All Shifts Available Pay Rate: Up to $40 per hour About the ... Participate in facility surveys and inspections conducted by authorized regulatory agencies, as ...

IVX Health

Infusion Registered Nurse (RN)

Orlando, FL · On-site

Join IVX Health as a Full-time Registered Nurse! Shift will include: Tuesday - Friday (7:30am - 4 ... Support Operations and Training - Assist in inventory management, prior authorizations, and ...

next page

Showing results 1-20

All JobsPrior Authorization Rn JobsFull Time Prior Authorization Rn JobsFull Time Prior Authorization Rn Jobs in Florida

Full Time Prior Authorization Rn information

What are Full Time Prior Authorization RNs?

Full Time Prior Authorization Registered Nurses (RNs) are healthcare professionals who work primarily in administrative roles to review and evaluate medical service requests. Their main responsibility is to determine if specific treatments, medications, or procedures meet insurance company criteria for coverage before they are provided to patients. They use their clinical knowledge to assess medical necessity and ensure compliance with healthcare policies and guidelines. These nurses typically interact with physicians, insurance companies, and patients to manage authorizations and appeals, ensuring that care is both appropriate and covered under a patient’s health plan.

What is the difference between Full Time Prior Authorization Rn vs Medical Coder?

AspectFull Time Prior Authorization RnMedical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), knowledge of medical coding systems
Work EnvironmentHealthcare facilities, insurance companies, utilization review departmentsMedical offices, hospitals, insurance companies, coding agencies
Job FocusReviewing and authorizing medical procedures and treatmentsTranslating medical records into standardized codes for billing

While both roles require healthcare knowledge, the Full Time Prior Authorization RN focuses on evaluating medical necessity for treatments, whereas Medical Coders translate medical documentation into codes for billing. Both are essential in healthcare administration but serve different functions within the patient care and billing process.

What are the key skills and qualifications needed to thrive as a Full Time Prior Authorization RN, and why are they important?

To thrive as a Full Time Prior Authorization RN, you need a strong nursing background (active RN license), in-depth knowledge of medical terminology, and experience with insurance processes or utilization review. Familiarity with prior authorization software, electronic health records (EHRs), and insurance payer portals is typically required. Exceptional attention to detail, critical thinking, and strong communication skills help you effectively evaluate medical necessity and advocate for patient care. These abilities ensure timely, accurate authorizations, reduce claim denials, and promote optimal patient outcomes.

What are some typical challenges faced by Full Time Prior Authorization RNs, and how can they be managed?

Full Time Prior Authorization RNs often encounter challenges related to navigating complex insurance guidelines, managing high caseloads, and ensuring timely communication between healthcare providers and payers. Staying organized, keeping up-to-date with frequently changing insurance policies, and developing strong collaboration skills with both clinical and administrative teams are key to success in this role. Leveraging electronic health records and standardized workflows can also help streamline the authorization process and reduce delays for patients.
What are the most commonly searched types of Prior Authorization Rn jobs in Florida? The most popular types of Prior Authorization Rn jobs in Florida are:
What cities in Florida are hiring for Full Time Prior Authorization Rn jobs? Cities in Florida with the most Full Time Prior Authorization Rn job openings:
Full Time Prior Authorization Rn jobs near you
Medical Assistant Prior Authorization Specialist | Community Health and Family Medicine| Day Shift |

Medical Assistant Prior Authorization Specialist | Community Health and Family Medicine| Day Shift |

UF Health

Gainesville, FL • On-site

$14.75 - $19/hr

Full-time

Posted 5 days ago

New

Job description

Overview

Under the direction of our ambulatory pharmacist this position will be responsible for prior authorizations for their assigned clinics.

The Medical Assistant provides patient care in a physician's office setting under the direct responsibility of a licensed physician. Clinical skills performed are within the scope of a Medical Assistant as defined by Florida Statutes 458.3485 and UFHP Clinical Policy and Procedure. The MA may also perform clerical, insurance, and medical record functions. May be required to float to other UFHP practices, as needed, for staffing.


Qualifications

Medical Assistant Minimum Education and Experience Requirements:

  • Candidate must be a graduate of an accredited course of study as a Certified or Registered Medical Assistant Accredited MA certifications include, but are not limited to, AAMA, NHA, NCCT, AMCA, AAMA and AMT.
  • EMT license can be used in lieu of an MA certification.
  • One year prior authorization experience preferred.
  • One year of direct patient care experience in an ambulatory care setting is preferred.
  • Person should display initiative, have the ability to multitask, and be able to assume additional responsibilities.
  • Proven ability to problem-solve and be a team member is essential.

Licensure/Certification/Registration:

  • Must possess and maintain current certification or registration as a Medical Assistant.
  • AHA or Red Cross Basic Life Support (CPR) is required or must be obtained within first 90 days of employment. Must maintain current Basic Life Support (CPR). Must successfully complete medication test within 30 days of hire  or Red Cross.

Motor Vehicle Operator Designation:

Will not operate vehicles for an assigned business purposes

Apply