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Overnight Prior Authorization Rn Jobs in Virginia

WomanCare Centers

Prior Authorization Nurse

Norfolk, VA · On-site

$25 - $31/hr

WomanCare Centers Prior Authorization Nurse We are a busy, patient-centered OB/GYN outpatient practice dedicated to providing compassionate, comprehensive care to women at every stage of life. Our ...

MFA Co

Prior-Authorization Technician- Pharmacy

Arlington, VA · On-site

$20.25 - $24.50/hr

Position Summary The Prior Authorization Technician will process prior authorizations and locate ... Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered Physical ...

MFA

Prior-Authorization Technician- Pharmacy

Arlington, VA · On-site

$23.46 - $30.50/hr

Position Summary The Prior Authorization Technician will process prior authorizations and locate ... Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered Physical ...

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$45 - $50/hr

Intake RN-PRN | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: About ... Facilitates intake, admission, and prior authorization process for incoming patients. * Performs ...

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$45 - $50/hr

Intake RN-PRN | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: About ... Facilitates intake, admission, and prior authorization process for incoming patients. * Performs ...

VCU Health System

Supports prior authorization requirements specific to emergent / same day prior authorizations and ... Current Registered Nurse license, BLS Certification. Licensure/Certification Preferred: Nursing ...

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Overnight Prior Authorization Rn information

What is an Overnight Prior Authorization RN?

An Overnight Prior Authorization RN is a Registered Nurse who works overnight shifts to review and process requests for prior authorization of medical services, procedures, or medications. Their role involves evaluating clinical documentation to determine if requested treatments meet insurance or organizational guidelines for approval. These nurses collaborate with providers, patients, and insurance companies to ensure timely and appropriate care. Working overnight allows for 24/7 coverage, supporting urgent cases and maintaining continuous workflow in healthcare authorization departments.

What are the key skills and qualifications needed to thrive as an Overnight Prior Authorization RN?

To thrive as an Overnight Prior Authorization RN, you need a current RN license, strong clinical judgement, and in-depth knowledge of insurance guidelines and medical necessity criteria. Familiarity with prior authorization software, electronic health records (EHR), and payer-specific systems is typically required. Exceptional attention to detail, critical thinking, and effective communication skills are vital for navigating complex cases and collaborating remotely. These skills ensure timely and accurate authorization decisions, supporting patient care and compliance during overnight shifts.

What are some unique challenges faced by Overnight Prior Authorization RNs, and how can they effectively manage them?

Overnight Prior Authorization RNs often work independently with limited immediate support, which can present challenges such as handling complex cases without direct peer consultation and maintaining focus during non-traditional hours. They must be adept at managing high volumes of authorization requests, prioritizing urgent cases, and communicating effectively with providers and insurance companies outside regular business hours. Staying organized, utilizing clear documentation, and leveraging electronic health record systems can help manage workload efficiently. Building strong relationships with day-shift colleagues for smooth case handoffs is also crucial for success in this role.

What is the difference between Overnight Prior Authorization Rn vs Medical Assistant?

AspectOvernight Prior Authorization RnMedical Assistant
CredentialsRegistered Nurse (RN) licensePost-secondary certificate or diploma
Work EnvironmentHospitals, clinics, insurance companiesDoctor's offices, clinics, outpatient facilities
Job FocusReviewing insurance authorizations, patient advocacyAssisting with patient care, administrative tasks

The Overnight Prior Authorization RN primarily handles insurance approvals and patient advocacy during overnight shifts, requiring RN licensure. In contrast, Medical Assistants focus on direct patient care and administrative support in outpatient settings. While both roles support healthcare operations, their credentials, responsibilities, and work environments differ significantly.

What are the most commonly searched types of Prior Authorization Rn jobs in Virginia?

The most popular types of Prior Authorization Rn jobs in Virginia are:

What cities in Virginia are hiring for Overnight Prior Authorization Rn jobs?

Cities in Virginia with the most Overnight Prior Authorization Rn job openings:

Overnight Prior Authorization Rn jobs near you

Prior Authorization Nurse

Norfolk, VA • On-site

WomanCare Center, PLC
See more jobs at WomanCare Center, PLCexternal

Other

PTO

Posted 11 days ago

Job description

WomanCare Centers Prior Authorization Nurse

We are a busy, patient-centered OB/GYN outpatient practice dedicated to providing compassionate, comprehensive care to women at every stage of life. Our team values communication, collaboration, and continuity of care—both in and out of the office. We're seeking an experienced Medication Prior Authorization Nurse to join our dynamic team in an in-person, non-remote position. The primary focus of this role is the timely and accurate management of medication prior authorizations, working closely with providers, pharmacies, insurance companies, and patients to facilitate access to prescribed medications.

Responsibilities:
  • Manage medication prior authorizations as the primary responsibility of the position, including initiating, completing, submitting, and tracking prior authorization requests.
  • Review medication orders and insurance requirements to determine appropriate prior authorization processes and required documentation.
  • Gather and submit supporting clinical documentation, including diagnoses, treatment history, laboratory results, and other information required for authorization.
  • Monitor pending prior authorizations and proactively follow up to ensure timely resolution and minimize delays in patient treatment.
  • Assist with appeals, reconsiderations, peer-to-peer requests, and alternative medication options when prior authorization requests are denied, as directed by the provider.
  • Maintain accurate and timely documentation of all prior authorization activities in the electronic health record (EHR).
  • Process medication refill requests as appropriate, ensuring clinical appropriateness and adherence to established protocols.
  • Stay current with payer requirements, medication authorization processes, and changes that may affect patient access to medications.
  • Other duties as assigned.
Qualifications Desired
  • Minimum of 2 years of nursing experience in Prior Authorizations.
  • Strong clinical assessment, critical thinking, and problem-solving skills.
  • Excellent communication, organization, documentation, and time-management skills.
  • Strong attention to detail and ability to manage multiple prior authorizations and follow-up tasks simultaneously.
  • Ability to work independently while collaborating effectively with providers, pharmacies, insurance companies, and members of the care team.
  • Compassionate, patient-centered approach to care.
  • Ability to work in person; this position is not eligible for remote work.
  • Familiarity with medication formularies.
  • Knowledge of common OB/GYN conditions, including prenatal care, contraception, menstrual issues, menopause, infections, and pregnancy complications.
Why Join Our Team?
  • Paid time off that increases with tenure.
  • Major federally recognized holidays off with pay.
  • Competitive benefits package with optional supplemental benefits.
  • Leadership dedicated to cultivating and maintaining a positive environment that encourages professional growth.
  • Opportunities to take on healthy challenges and develop your clinical and administrative skills.
  • A collaborative team environment with coworkers who encourage and support one another in achieving success.

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