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Prior Authorization Lvn Jobs (NOW HIRING)

Managed Staffing

Licensed Vocational Nurse - LPN

RI · Remote

$28 - $30/hr

Licensed Vocational Nurse (LPN) - Remote Prior Authorization 100% Remote - Anywhere in the U.S. Schedule: Monday-Friday, Day Shift (No weekends unless overtime is required) About the Role We are ...

Cuero Regional Hospital

LVN

Cuero, TX · On-site

$22.75 - $30.50/hr

The LVN is responsible for the direct and indirect care of the clinic patients. * The LVN assists ... obtaining prior authorizations on medications, procedures, tests ordered by providers, and ...

THE CHILDREN'S CLINIC

LVN

Long Beach, CA · On-site

$24.79 - $31.49/hr

The LVN will ensure the delivery of quality patient care and the efficiency of patient flow ... Refill Request & Prior Authorization for Medication. * Case Management / Patient Education.

THE CHILDREN'S CLINIC

LVN

Bellflower, CA · On-site

$27.49 - $31/hr

The LVN will ensure the delivery of quality patient care and the efficiency of patient flow ... Refill Request & Prior Authorization for Medication. * Case Management / Patient Education.

THE CHILDREN'S CLINIC

LVN

Long Beach, CA · On-site

$27.49 - $31.49/hr

The LVN will ensure the delivery of quality patient care and the efficiency of patient flow ... Refill Request & Prior Authorization for Medication. * Case Management / Patient Education.

CivicMinds, Inc.

Licensed Vocational Nurse

Los Angeles, CA · On-site

$31 - $41.75/hr

Licensed Vocational Nurse Location: West Hollywood, CA 90069||West Hollywood, CA 90046 || Los ... prior authorizations and medication management. * Review laboratory results and communicate ...

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Prior Authorization Lvn information

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How much do prior authorization lvn jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for prior authorization lvn in the United States is $31.85, according to ZipRecruiter salary data. Most workers in this role earn between $26.44 and $35.58 per hour, depending on experience, location, and employer.

What are some common challenges faced by Prior Authorization LVNs, and how can they be managed effectively?

Prior Authorization LVNs often encounter challenges such as navigating complex insurance requirements, managing high volumes of authorization requests, and ensuring timely communication between providers, patients, and payers. Staying organized and up-to-date on payer policies is crucial for success. Collaborating closely with physicians, billing teams, and insurance representatives helps resolve issues efficiently and ensures patients receive necessary care without unnecessary delays. Ongoing training and use of electronic health record (EHR) systems can further streamline the workflow and reduce stress.

What is the difference between Prior Authorization Lvn vs Medical Assistant?

AspectPrior Authorization LvnMedical Assistant
CredentialsLVN license, certification in medical billing or authorizationHigh school diploma, certification in medical assisting
Work EnvironmentClinics, hospitals, insurance officesDoctor's offices, clinics, outpatient facilities
Job FocusReviewing insurance authorizations, coordinating approvalsPatient intake, basic clinical tasks, administrative support

While both roles work in healthcare settings, a Prior Authorization LVN specializes in managing insurance approvals and has nursing credentials, whereas a Medical Assistant handles clinical and administrative tasks without nursing licensure. The LVN's role is more focused on insurance processes, making it essential for healthcare facilities that require authorization management.

What are the key skills and qualifications needed to thrive as a Prior Authorization LVN, and why are they important?

To thrive as a Prior Authorization LVN, you need an active LVN license, strong clinical judgment, and in-depth knowledge of insurance guidelines and medical terminology. Familiarity with electronic medical record (EMR) systems, prior authorization software, and payer portals is typically required. Excellent communication, attention to detail, and organizational skills help ensure accurate documentation and effective coordination with providers and insurance companies. These competencies are crucial for expediting patient care, reducing denials, and supporting efficient healthcare operations.

What does a Prior Authorization LVN do?

A Prior Authorization LVN (Licensed Vocational Nurse) is responsible for reviewing and processing requests for medical procedures, medications, or services that require approval from an insurance provider before they are performed. They assess clinical documentation, communicate with healthcare providers and insurance companies, and ensure that requests comply with insurance guidelines. Their work helps ensure that patients receive necessary care while also helping manage healthcare costs. Additionally, they may educate patients and providers about prior authorization processes and requirements.
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Prior Authorization Lvn jobs near you
Infographic showing various Prior Authorization Lvn job openings in the United States as of July 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 100% In-person job distribution, with an average salary of $66,243 per year, or $31.8 per hour.

Prior Authorization LVN

LSMA Management Inc

San Bernardino, CA • On-site

$35 - $40/hr

Full-time

Posted 7 days ago

Job description

Description:

JOB SUMMARY:

The Prior Authorization Nurse (LVN) is responsible for performing clinical review and evaluation of authorization requests to ensure medical necessity, appropriate utilization of healthcare services, and compliance with regulatory and health plan requirements. This role conducts prospective, concurrent, and retrospective review of medical services including specialty care, diagnostic procedures, elective admissions, post-acute services, and out-of-network referrals. The Prior Authorization LVN collaborates with providers, health plans, and internal clinical teams to support timely care coordination while ensuring adherence to CMS, NCQA, and organizational guidelines. The position serves as a clinical resource to Prior Authorization Coordinators and supports efficient utilization management operations.

Requirements:

MINIMUM & PREFERRED QUALIFICATIONS:


Education/Training

Minimum: High School diploma or equivalent required. Graduate from an accredited Vocational Nursing Program.


Experience

Minimum: At least one year of clinical experience in a healthcare setting. Basic knowledge of medical terminology, utilization management processes, and clinical care practices.

Preferred: Two or more years of utilization management, prior authorization, case management, or managed care experience. Experience working in an MSO, IPA, health plan, or medical group environment. Experience using Milliman Care Guidelines (MCG), InterQual, or similar criteria tools. Knowledge of ICD-10, CPT, and HCPCS coding. Experience with electronic health record and utilization management systems.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.


Certification(s)

Current, active, unrestricted California LVN license required.

Skills, Knowledge & Abilities

· Knowledge of utilization management principles, medical necessity criteria, and managed care processes.

· Understanding of clinical documentation and healthcare delivery systems.

· Familiarity with regulatory requirements including NCQA, CMS, and HIPAA.

· Strong verbal and written communication skills.

· Ability to effectively communicate with physicians, providers, and interdisciplinary teams.

· Ability to provide clear and professional clinical guidance.

· Ability to review and interpret clinical information and apply established criteria.

· Strong organizational and prioritization skills.

· Ability to manage multiple tasks and deadlines efficiently.

· Proficiency in Microsoft Office (Word, Excel, Outlook).

· Ability to use electronic medical records and authorization systems.

· Ability to learn and adapt to new software and technology.

· Strong attention to detail and accuracy.

· Ability to maintain confidentiality and professionalism.

· Ability to work independently and as part of a team.

· Ability to review and interpret clinical information and apply established criteria.

· Strong organizational and prioritization skills.

· Ability to manage multiple tasks and deadlines efficiently.

· Proficiency in Microsoft Office (Word, Excel, Outlook).

· Ability to use electronic medical records and authorization systems.

· Ability to learn and adapt to new software and technology.

· Strong attention to detail and accuracy.

· Ability to maintain confidentiality and professionalism.

· Ability to work independently and as part of a team.


PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:

The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. Prolonged sitting, typing, and computer work. Occasional standing, walking, bending, and reaching. Ability to lift up to 20 pounds occasionally. Ability to concentrate for extended periods while reviewing clinical documentation. Ability to manage multiple priorities in a fast-paced environment. Ability to exercise sound clinical judgment and decision-making. Frequent interaction with healthcare providers and internal staff via phone and electronic communication. Low to moderate noise level consistent with office environment.


PAY RANGE

$35.00 - $40.00 / hourly

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