Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company?
Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company?
Prior Authorization Specialist
Somerville, MA · Remote
$28.30/hr
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Job Summary Summary Reviews and processes prior authorization and referral requests for medical ...
New
Prior Authorization Specialist
Somerville, MA · Remote
$28.30/hr
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Job Summary Summary Reviews and processes prior authorization and referral requests for medical ...
New
Prior Authorization Specialist
Somerville, MA · On-site +1
$28.30/hr
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Job Summary Summary Reviews and processes prior authorization and referral requests for medical ...
Prior Authorization Specialist
Somerville, MA · On-site +1
$28.30/hr
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Job Summary Summary Reviews and processes prior authorization and referral requests for medical ...
Pharmacy Prior Authorization Specialist
Waltham, MA · On-site +1
$22.25 - $29/hr
Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...
Pharmacy Prior Authorization Specialist
Waltham, MA · On-site +1
$22.25 - $29/hr
Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...
Pharmacy Prior Authorization Specialist
Waltham, MA · On-site
$22 - $28.50/hr
Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...
Pharmacy Prior Authorization Specialist
Waltham, MA · On-site
$22 - $28.50/hr
Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Time Type: Full time Department: Referrals All Locations: 151 Orleans Street Position Summary:
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Time Type: Full time Department: Referrals All Locations: 151 Orleans Street Position Summary:
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Time Type: Full time Department: Referrals All Locations: 151 Orleans Street Position Summary:
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Time Type: Full time Department: Referrals All Locations: 151 Orleans Street Position Summary:
Prior Authorization Technician - Pharmacy Technician
$18.50 - $22.50/hr
... prior authorizations, as well as collaborating with patients and various funding sources, such as ... We are seeking experienced, state registered pharmacy technicians. If the candidate lives in a ...
Quick apply
Prior Authorization Technician - Pharmacy Technician
$18.50 - $22.50/hr
... prior authorizations, as well as collaborating with patients and various funding sources, such as ... We are seeking experienced, state registered pharmacy technicians. If the candidate lives in a ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Team Lead, Prior Authorizations
Somerville, MA · On-site +1
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Team Lead, Prior Authorizations
Somerville, MA · On-site +1
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Clinical Appeals RN
Boston, MA · Remote
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time ...
Clinical Appeals RN
Boston, MA · Remote
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time ...
Clinical Appeals RN
Boston, MA · On-site
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time ...
Clinical Appeals RN
Boston, MA · On-site
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time ...
LPN /RN
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
LPN /RN
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
LPN /RN
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
LPN /RN
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
RN Pharmacy & Medication Coordinator
Andover, MA · On-site
$105K - $110K/yr
In this full-time role, you'll work closely with physicians and pharmacy providers to coordinate ... prior authorizations that support safe, efficient resident care. This position is ideal for an ...
Quick apply
RN Pharmacy & Medication Coordinator
Andover, MA · On-site
$105K - $110K/yr
In this full-time role, you'll work closely with physicians and pharmacy providers to coordinate ... prior authorizations that support safe, efficient resident care. This position is ideal for an ...
Registered Nurse (RN) Case Manager
$45 - $55/hr
Obtain prior authorizations for transportation, therapy, medical equipment, and other services ... Paid time off for full-time employees * Six paid holidays * 401(k) * Complimentary employee meals ...
Quick apply
Registered Nurse (RN) Case Manager
$45 - $55/hr
Obtain prior authorizations for transportation, therapy, medical equipment, and other services ... Paid time off for full-time employees * Six paid holidays * 401(k) * Complimentary employee meals ...
Prior Authorization Specialist - Billing Coordinator
Boston, MA · On-site
$21 - $28.30/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Prior Authorization Specialist - Billing Coordinator
Boston, MA · On-site
$21 - $28.30/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Prior Authorization Specialist - Billing Coordinator
Boston, MA · On-site
$21 - $28.30/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Prior Authorization Specialist - Billing Coordinator
Boston, MA · On-site
$21 - $28.30/hr
The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance ...
Surgical Scheduler and Surgery Authorization
North Andover, MA · On-site
$19 - $24.50/hr
Busy medical practice seeking an individual with experience in surgical scheduling and prior authorizations. Full Time, Monday - Friday, no weekends or holidays. This position is responsible for ...
Surgical Scheduler and Surgery Authorization
North Andover, MA · On-site
$19 - $24.50/hr
Busy medical practice seeking an individual with experience in surgical scheduling and prior authorizations. Full Time, Monday - Friday, no weekends or holidays. This position is responsible for ...
Registered Nurse
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN Note: The ... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols.
Registered Nurse
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN Note: The ... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols.
Full Time Prior Authorization Rn information
What is a full time prior authorization RN?
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 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 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 is the difference between Full Time Prior Authorization Rn vs Medical Coder?
| Aspect | Full Time Prior Authorization Rn | Medical Coder |
|---|---|---|
| Credentials | RN license, certification in case management or utilization review | Certification in coding (CPC, CCS), knowledge of medical coding systems |
| Work Environment | Healthcare facilities, insurance companies, utilization review departments | Medical offices, hospitals, insurance companies, coding agencies |
| Job Focus | Reviewing and authorizing medical procedures and treatments | Translating 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 cities in Massachusetts are hiring for Full Time Prior Authorization Rn jobs?
Cities in Massachusetts with the most Full Time Prior Authorization Rn job openings:
$30/hr
Full-time
Medical, Dental, Vision
Re-posted 2 days ago
Job description
Company Description
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
Daily Responsibilities: Â
Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.
Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care
Educate providers on utilization and medical management processes
Hours for this Position:
Monday- Friday; 8AM-5PM
Pay rate starts at $30 per hour
Advantages of this Opportunity:Â
Competitive salary, negotiable based on relevant experience
Benefits offered, Medical, Dental, and Vision
Fun and positive work environment
Qualifications
RN licensure
Candidates must have a car- mass transportation in Boston doesn't go to Waltham
2+ years of clinical nursing experience
Some sort of Prior Authorization experience from either another managed care company or clinical setting
Additional Information
Interested in being considered?Â
If you are interested in applying to this position, please contact (Katleen Angala, 321-445-8243) and click the Green I'm Interested Button to email your resume.Â
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003