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Internship Prior Authorization Rn Jobs (NOW HIRING)

W3R

RN Prior Authorization

Austin, TX

The Registered Nurse conducts pre-service, concurrent/ retrospective reviews. * They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to ...

Arizona Priority Care

Prior Cert RN Manager

Chandler, AZ · Hybrid

$96K - $100K/yr

As the Pre Cert RN Manager, you will lead a high-performing team focused on ensuring timely ... Lead and support the Prior Authorization Supervisor and nursing staff to ensure effective daily ...

Regal Medical Group, Inc.

Position Summary: The role of the Director, Prior Authorization is to oversee the prior ... RN license.

Regal Medical Group, Inc.

$45 - $50/hr

The role of the Prior Authorization Review Nurse, LVN/RN is to promote the quality and cost effectiveness of medical care by applying clinical judgement and the appropriate application of policies ...

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How much do internship prior authorization rn jobs pay per hour?

As of May 30, 2026, the average hourly pay for internship prior authorization rn in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What is the difference between Internship Prior Authorization Rn vs Medical Billing Specialist?

AspectInternship Prior Authorization RnMedical Billing Specialist
CredentialsRN license, internship experienceCertification in medical billing or coding
Work EnvironmentHospitals, clinics, healthcare facilitiesMedical offices, billing companies, healthcare providers
Employer & Industry UsageHealthcare providers requiring authorization for patient careHealthcare billing and insurance reimbursement

The Internship Prior Authorization RN focuses on obtaining approval for patient treatments, requiring nursing credentials and clinical experience. In contrast, a Medical Billing Specialist handles billing processes, insurance claims, and coding. Both roles are essential in healthcare but serve different functions—one ensures proper authorization for care, the other manages financial reimbursement.

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Internship Prior Authorization Rn jobs near you

Prior Authorization Temp Nurse Case Manager

Care Navigators On Demand

Northridge, CA • On-site

$38 - $42/hr

Temporary

Posted 19 days ago

Job description

Job Description
Prior Authorization Temp Nurse Case Manager, RN
Northridge, CA
4-Month Contract Assignment
  • Quick On-Boarding/Placement Process
  • Career Stepping Stone from Bedside Nursing to Case Management (acute care experience and working knowledge of pre-auth process required)

Description
The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests. The PACM will review for appropriate care and setting, and following guidelines/policies, will approve services when indicated. If not indicated, PACM will forward requests to the appropriate physician or medical director with recommendations for other determinations, ensuring that the member is receiving the appropriate quality care in a preferred setting, while making sure regulatory guidelines are followed.
1. Understand, promote and review with the principles of medical management to facilitate the right care at the right time in the right setting.
2. Communicate effectively and interact with providers, staff and health plans daily regarding medical management and referral authorization issues.
3. Maintain a working relationship with PACM colleagues, the pre-auth coordinator team, high-risk nurse case managers, inpatient nurse case managers, medical directors, and network management.
4. Research alternative care plans and when necessary, assist in the routing of members to the most appropriate care/setting, in order to provide right care/right setting.
5. When necessary, act as liaison between the case managers, UM coordinators, contracted providers (PCPs/specialists/ancillary), and the members/families.
6. Perform case reviews base on key screening outpatient indicators, and evaluate the PCP submitted plan of care for its completeness of documentation, consistency of treatment with medical groups clinical practice guidelines, adherence to standard evidence-based or consensus guidelines, and health plan and CMS guidelines and/or medical policies.
7. Maintain regulatory Turnaround Time Standards per regulatory guidelines.
8. Document accurately and completely all necessary information in authorization notes.
9. Understand all applicable capitation contracts and how they apply to review duties.
10. For those PACMs involved in DME, understand the contracts, and need to review rental vs. purchase approvals, and continued use so that equipment is picked up when needed.
11. When appropriate, coordinate and review for medical necessity and appropriate utilization any ancillary professional services, i.e. (home health, infusion, PT, OT, ST, etc.).
12. Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner.
13. Participates in "service recovery" through follow-up with an upset patient or provider, gathering information, and demonstrating empathy.
14. Identifies network needs and report to management for potential contracting opportunities.
Qualifications
1.Graduate from an accredited Registered Nursing Program
2.Current California RN License
3.Minimum of 1 year acute experience
4.Knowledge of Managed Care preferred.
5.Knowledge of NCQA, CMS, HSAG, and health plan requirements related to utilization management.
6.Knowledgeable with the pre-authorization process and workflow, with prior authorization experience preferred.
7.Knowledgeable in computers and MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point).
8.Ability to deal with responsibility with confidential matters
9.Ability to work in a multi-tasking, fast-paced, high-stress environment.
Compensation
$38-$42/Hr
Negotiable based on experience

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