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Full Time Prior Authorization Rn Jobs (NOW HIRING)

MC-Rx

Prior Authorization Coordinator

Gainesville, GA · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our ...

GI Associates

Prior Authorization Specialist

Wausau, WI · On-site

$19.25 - $25.75/hr

This is a full-time, on-site position based in our Wausau office (1.0 FTE) with the potential for a ... Obtains pre-authorizations/pre-certifications for procedures, radiology/diagnostic testing ...

Sluhn

Medication Prior Authorization Specialist

Allentown, PA · On-site

$17.75 - $23.75/hr

... nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Medication Prior Authorization Specialist ...

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Full Time Prior Authorization Rn information

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

As of Jul 14, 2026, the average hourly pay for full time prior authorization rn in the United States is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $50.00 per hour, depending on experience, location, and employer.

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 cities are hiring for Full Time Prior Authorization Rn jobs? Cities with the most Full Time Prior Authorization Rn job openings:
What are the most commonly searched types of Prior Authorization Rn jobs? The most popular types of Prior Authorization Rn jobs are:
What states have the most Full Time Prior Authorization Rn jobs? States with the most job openings for Full Time Prior Authorization Rn jobs include:
Full Time Prior Authorization Rn jobs near you

Prior Authorization Specialist

Riverhills Healthcare, Inc

Cincinnati, OH • Hybrid

$18 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Job description

About Us:

For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.

Position: Prior Authorization Specialist

Location: Norwood Office

Department: Billing

Schedule: Monday-Friday, 8am-4:30pm, Hybrid, 2 days in office, 3 days remote after full in office training.

Pay: $18-22 per hour

Key Benefits for Full-Time Employees:

  • Competitive pay based on experience, minimum $18
  • 401k with Profit Sharing and 4% Company Match
  • Comprehensive Medical, Dental, and Vision insurance
  • Long-Term and Short-Term Disability Insurance
  • Company Paid Life Insurance
  • Paid Holidays
  • Over three weeks of Paid Time Off
  • Continuing Education Reimbursement
  • Uniform Allowance
  • Free Parking

Responsibilities:

As a Prior Authorization Specialist at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include:

  • Streamline pre-certification, authorization, and referral processes, ensuring compliance with insurance requirements
  • Coordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determination
  • Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients
  • Ensure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin procedures
  • Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet
  • Initiate patient education on available assistance programs

Background and Experience:

  • 1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice
  • Pain Management experience is a plus
  • Experience with an Electronic Medical Record (EMR) and practice management system
  • Knowledge of Medicare/Medicaid and major insurance carrier's guidelines
  • Working knowledge of ICD-9-10 medical coding and billing and medical terminology
  • Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors

If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice.

Equal Opportunity/Drug-Free Workplace:

Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace.

#IND3

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