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Full Time Prior Authorization Rn Jobs in Rochester, NY

Angels In Your Home

Registered Nurse

Rochester, NY · On-site

$75K - $83K/yr

Job Type Full-time Description Position Summary The RN Case Manager is responsible for completing ... Ensure all care delivery is compliant with the care plan, authorized tasks, and scope-of-practice ...

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Full Time Prior Authorization Rn information

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$7

$41

$71

How much do full time prior authorization rn jobs pay per hour?

As of May 30, 2026, the average hourly pay for full time prior authorization rn in Rochester, NY is $41.68, according to ZipRecruiter salary data. Most workers in this role earn between $31.06 and $49.33 per hour, depending on experience, location, and employer.

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 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 most commonly searched types of Prior Authorization Rn jobs in Rochester, NY? The most popular types of Prior Authorization Rn jobs in Rochester, NY are:
Full Time Prior Authorization Rn jobs near you
Prior Authorization Specialist , Diagnostic Imaging

Prior Authorization Specialist , Diagnostic Imaging

Thompson Health

Canandaigua, NY

$20 - $24.50/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Thompson Health rating

7.7

Company rating: 7.7 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

Job description

Schedule: Full time, days: Mon - Fri: 730aam - 4:00pm.

Pay Range: $20.00 - $24.50, based on experience

Benefits:

  • Health, dental, vision insurance
  • Tuition reimbursement up to $6000/year
  • Contribution and match on Retirement Plan
  • Four weeks paid time off
  • Access to Success coaches
  • Free parking

Company Culture: Thompson Health has a culture of empowerment. At Thompson, interdisciplinary teams come together to improve care, your suggestions are welcomed and your ideas are part of the solution. Three of our executives have an RN background so we understand the importance of the patient experience! 

  • Focus on CARES values: Commitment, Action, Respect, Excellence, and Service
  • Focus on Employee Wellness: Biometric screenings, Wellness programs, Onsite gym, Zen Room, Community Shared Agriculture program, Access to Success Coach
  • Staff Recognition platforms: Shining Stars, CARESCount website

Responsibilities:

  • Performs with minimum direction and considerable latitude for independent judgement, obtains prior authorizations for both standard and complex requests.
  • Provides multiple & complex details to insurance carrier by anticipating their questions when reviewing & retrieving relevant info from the electronic medical record.
  • Responsible for planning, execution, appeals and efficient follow through on all aspects of the process which as direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care and follow up.
  • May train and coordinate activities of peers or support staff.

Qualifications:

  • Required Associate’s degree in Medical, Secretarial or related field & a minimum of 3years of relevant exp.; or an equivalent combination of education & experience.
  • Medical Terminology, experiences with surgical/appointment scheduling software (such as Flowcast), and electronic medical records, preferred.
  • Demonstrated customer relations skills.

    Pay Range: $20.00 - $24.50

    Starting Pay: Based on Experience

    Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply

    What Thompson Health employees say

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