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Pre Authorization Nurse Jobs (NOW HIRING)

Hudson Regional Hospital

Insurance Navigator

Secaucus, NJ · On-site

$20 - $25/hr

Connect patients, doctors' offices, and insurance companies to help resolve pre-authorization issues. * Teamwork and Communication: * Work well with doctors, nurses, and other healthcare staff to get ...

Hudson Regional Hospital

Insurance Navigator

Secaucus, NJ · On-site

$18 - $24/hr

Connect patients, doctors' offices, and insurance companies to help resolve pre-authorization issues. * Teamwork and Communication: * Work well with doctors, nurses, and other healthcare staff to get ...

WVU Medicine

Insurance Authorization Specialist II

$18.50 - $24.50/hr

... pre-certification or pre-authorization at the time services are requested or when notified by ... Counselor, Schedulers, and Nurses. 15. Uses hospital communications systems (fax, pagers ...

Hudson Regional Hospital

Insurance Navigator

Secaucus, NJ · On-site

$20 - $22/hr

Connect patients, doctors' offices, and insurance companies to help resolve pre-authorization issues. * Teamwork and Communication: * Work well with doctors, nurses, and other healthcare staff to get ...

WVU Medicine

Insurance Authorization Specialist II

$18.50 - $24.50/hr

... pre-certification or pre-authorization at the time services are requested or when notified by ... Counselor, Schedulers, and Nurses. 15. Uses hospital communications systems (fax, pagers ...

West Virginia University Health System

$18.50 - $24.75/hr

... Nurse license issued by the state in which services will be provided or current multi-state ... Notifies treatment team of missing documentation pre-service. 16. Maintains assigned Work Queues in ...

WVU Medicine

Clinical Authorization Specialist

Morgantown, WV · On-site

$18.50 - $24.75/hr

... Nurse license issued by the state in which services will be provided or current multi-state ... Notifies treatment team of missing documentation pre-service. 16. Maintains assigned Work Queues in ...

WVU Medicine

Clinical Authorization Specialist

Morgantown, WV · On-site

$18.50 - $24.75/hr

... Nurse license issued by the state in which services will be provided or current multi-state ... Notifies treatment team of missing documentation pre-service. 16. Maintains assigned Work Queues in ...

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Pre Authorization Nurse information

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How much do pre authorization nurse jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for pre authorization nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is a pre authorization nurse?

Pre Authorization Nurses are registered nurses who evaluate and process requests for medical procedures, treatments, or medications to determine if they meet insurance or healthcare plan requirements for coverage. They review clinical information provided by healthcare providers, assess medical necessity, and coordinate with insurance companies to approve or deny requests. Their work ensures that patients receive appropriate care while helping healthcare organizations comply with payer guidelines and manage costs.

What are the key skills and qualifications needed to thrive as a pre authorization nurse?

To thrive as a Pre Authorization Nurse, you need a solid background in nursing practices, a current nursing license (RN or LPN), and knowledge of insurance and medical necessity guidelines. Familiarity with health insurance portals, electronic medical records (EMR), and utilization management software is typically required. Attention to detail, strong communication, and organizational skills help in efficiently coordinating with providers and insurers. These competencies are crucial for ensuring timely, accurate authorization of medical services and optimizing patient care while managing healthcare costs.

What are the main challenges a pre authorization nurse faces when coordinating with insurance companies?

Pre Authorization Nurses often encounter challenges such as navigating complex insurance policies, handling high volumes of requests, and ensuring timely communication between healthcare providers and insurers. They must be detail-oriented to avoid delays or denials and need strong interpersonal skills to advocate for patients while maintaining professionalism with insurance representatives. Staying updated on policy changes and documentation requirements is also crucial for success in this role.

What is the difference between Pre Authorization Nurse vs Utilization Review Nurse?

AspectPre Authorization NurseUtilization Review Nurse
CredentialsRN license, possibly certifications in case managementRN license, often with certifications in utilization review or case management
Work EnvironmentHealthcare facilities, insurance companies, or telehealthInsurance companies, healthcare organizations, or telehealth
Employer & IndustryHospitals, insurance providers, healthcare agenciesInsurance companies, managed care organizations

Pre Authorization Nurses primarily review requests before services are provided to ensure coverage, while Utilization Review Nurses evaluate the necessity of ongoing or completed treatments. Both roles require similar credentials and often work within insurance or healthcare settings, but their focus points differ in the patient care timeline.

What does a pre-authorization nurse do?

A pre-authorization nurse reviews insurance requests for medical procedures or treatments to determine coverage eligibility. They assess patient information, verify medical necessity, and communicate with healthcare providers and insurance companies to obtain approval before services are provided.
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Pre Authorization Nurse jobs near you
Infographic showing various Pre Authorization Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Prior Authorization RN in New York, NY

Vivian Health

Manhattan, NY • On-site

$90K - $108K/yr

Other

Posted 17 days ago

Job description

Prior Authorization RN

Pre-Authorization RN
Compensation
Salary Range: $90,000 – $108,000 per year
Bonus / Commission (if applicable):
This role is eligible for a $15,000 sign-on bonus.
Location: Lower Manhattan, NY (Training) / Remote
Hybrid training transitioning to Remote
Position Summary
As a Pre-Authorization RN, you will support care coordination by reviewing and processing authorization requests in alignment with regulatory and organizational guidelines. This role involves collaboration with interdisciplinary teams to ensure timely and appropriate care delivery. Following a structured hybrid training period, this position transitions to a fully remote setting while maintaining high standards of clinical accuracy and compliance.
Responsibilities
? Schedule / Shift

  • Shift details: Monday – Friday (Business Hours)
  • Hours per week: 40
? Key Duties:
  • Review and process authorization requests in accordance with Medicare, Medicaid, and internal guidelines
  • Collaborate with care managers, nurses, and providers to ensure timely and appropriate service delivery
  • Coordinate completion of UAS-NY assessments to reflect members’ current clinical status
  • Ensure care plans are accurate, updated, and aligned with member needs
  • Maintain accurate documentation and support compliance with utilization management standards
Requirements
? Education
  • Required: Associate’s Degree in Nursing
  • Preferred (if applicable): Bachelor’s Degree in Nursing (BSN)
? Licenses & Certifications
  • Required: Active New York State Registered Nurse (RN) license
  • Additional certifications (if applicable): CCM certification preferred
? Skills:
  • Strong knowledge of Medicare and Medicaid regulations
  • Experience in prior authorization or utilization review processes
  • Excellent clinical judgment, assessment, and decision-making skills
  • Proficiency in Microsoft Office (Word, Excel) and familiarity with InterQual preferred
About Us
RCM Healthcare Services works with professionals across schools, healthcare, and community-based settings nationwide. We support both contract and direct hire opportunities, connecting people early in their careers and experienced professionals to roles that align with their experience and preferences. With more than 50 years of staffing experience, our team understands the environments you’re stepping into and what it takes to be successful in them. We stay closely involved from first conversation through placement, with consistent communication, a reliable point of contact, and follow-through at every step. We’re committed to caring for the professionals we work with and the communities they support, and offer competitive pay and benefits designed to support your well-being. RCM Healthcare Services is Joint Commission certified, reflecting a commitment to quality, compliance, and a consistent experience.
Equal Employment Opportunity & Reasonable Accommodation
RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us and we will engage in an interactive process to support your needs.
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