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Prior Authorization Nurse Jobs in Springfield, IL

Springfield Clinic

RN - (Float Pool)

Springfield, IL

... prior authorizations or certifications as needed. * Serve as a patient advocate by protecting ... Educated as a CMA, LPN or RN by an approved program. Licenses/Certificates * Current licensure in ...

Springfield Clinic

RN - (Float Pool)

Springfield, IL · On-site

... prior authorizations or certifications as needed. * Serve as a patient advocate by protecting ... Educated as a CMA, LPN or RN by an approved program. Licenses/Certificates * Current licensure in ...

Orthopaedic Center Of Illinois

RN/LPN/MA

Springfield, IL · On-site

$17 - $40/hr

Registered Nurse / Licensed Practical Nurse / Medical Assistant Orthopedic Center of Illinois ... Manage prior authorizations, referrals, and prescription refill requests in coordination with ...

Springfield Clinic

LPN - Allergy

Springfield, IL · On-site

$23.75 - $32.50/hr

... prior authorizations or certifications as needed. * Serve as a patient advocate by protecting ... Educated as an LPN or CMA by an approved program. Licenses/Certificates * Current licensure in the ...

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Showing results 21-40

All JobsPrior Authorization Nurse JobsPrior Authorization Nurse Jobs in Springfield, IL

Prior Authorization Nurse information

See Springfield, IL salary details

$17

$38

$64

How much do prior authorization nurse jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for prior authorization nurse in Springfield, IL is $38.27, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $42.88 per hour, depending on experience, location, and employer.

What is a prior authorization nurse?

Prior Authorization Nurses are registered nurses who evaluate medical requests and determine if procedures, medications, or services meet clinical guidelines for insurance coverage. They work closely with healthcare providers, insurance companies, and patients to ensure that prior authorization requirements are met before treatments or medications are approved. Their role helps streamline care delivery, reduce unnecessary costs, and ensure patients receive appropriate, covered services in a timely manner.

What does a prior authorization nurse do?

As a prior authorization nurse, you review requests for authorization for specific medications, treatments, or surgeries. Your duties include reviewing medical records and documents related to the application. You consider each prior authorization request and collect evidence and patient information to support your decision. You communicate with the insurance provider to obtain additional information if needed. Your responsibilities in this position also involve ensuring the authorization meets regulations and requirements and contractual obligations of all parties involved. Your job can also require coordinating with administrators and healthcare providers to gain necessary information and ensure that patients receive authorized care.

What are the key skills and qualifications needed to thrive as a prior authorization nurse, and why are they important?

To thrive as a Prior Authorization Nurse, you need a solid background in nursing, knowledge of insurance guidelines, and an active RN license. Familiarity with prior authorization software, electronic health records (EHRs), and payer-specific portals is typically required. Strong attention to detail, critical thinking, and effective communication help in collaborating with providers and navigating complex cases. These skills are essential to ensure accurate, timely authorization of medical services, which directly impacts patient care and healthcare reimbursement.

What are some common challenges faced by prior authorization nurses in coordinating with insurance providers?

Prior Authorization Nurses often encounter challenges such as navigating varying requirements from different insurance providers, managing tight turnaround times for approvals, and ensuring that clinical documentation is thorough and accurate. Effective communication and attention to detail are essential, as missing or unclear information can delay authorizations. Building collaborative relationships with providers, physicians, and insurance representatives helps streamline the process and improves patient outcomes.

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

AspectPrior Authorization NurseUtilization Review Nurse
CredentialsRN license, possibly certifications in case managementRN license, certifications in case management or utilization review
Work EnvironmentHealthcare facilities, insurance companies, or telehealthHospitals, insurance companies, or managed care organizations
Job FocusPre-authorization of specific procedures or treatmentsReviewing medical necessity and appropriateness of ongoing care

While both roles involve nursing expertise and work within healthcare and insurance settings, the Prior Authorization Nurse primarily focuses on obtaining approval before procedures, whereas the Utilization Review Nurse evaluates ongoing care for medical necessity. Understanding these differences helps in choosing the right career path or job search focus.

More about Prior Authorization Nurse jobs

What are the most commonly searched types of Prior Authorization Nurse jobs in Springfield, IL?

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For Prior Authorization Nurse jobs in Springfield, IL, the most frequently searched job titles are:

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Cities near Springfield, IL with the most Prior Authorization Nurse job openings:

Prior Authorization Nurse jobs near you
Infographic showing various Prior Authorization Nurse job openings in Springfield, IL as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $79,607 per year, or $38.3 per hour.

RN - (Float Pool)

Springfield Clinic

Springfield, IL

Full-time

Re-posted 11 days ago

Springfield Clinic rating

6.7

Company rating: 6.7 out of 10

Based on 59 frontline employees who took The Breakroom Quiz

531st of 888 rated healthcare providers

Job description

The Flex Clinical Staff member is responsible for patient care according to individual needs of the patient population within the rules and regulations of their scope of practice and managing the operations of the office on a daily basis.

Job Relationships

Reports to the Operations Manager

Principal Responsibilities

  • Obtain medical information, chief complaints, vital signs and diagnostic test results in preparation for physician examination and documents in the medical record.
  • Assist the physician in the examination treatment of the patient by handing instruments, providing dressings, preparing equipment, etc. according to Infection Control Policy.
  • Administer care treatments prescribed by the provider within scope of practice.
  • Provides for continuity of care with patient treatment plans prescribed by the provider by putting in orders, scheduling tests and procedures, relaying patient results to providers and patients as appropriate, make referrals to other agencies, obtaining prior authorizations or certifications as needed. 
  • Serve as a patient advocate by protecting patient rights and give attention to complaints regarding service.
  • Provide emotional support and guidance to patients/family.
  • Demonstrate professionalism by adhering to performance standards including dress code.
  • Insure confidentiality for patients and staff.
  • Maintain knowledge by attending appropriate education programs, reading current journals and literature, and documents for yearly evaluation.
  • Comply with the Springfield Clinic incident reporting policy and procedures.
  • Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
  • Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
  • Orient new personnel to specialty.
  • Perform other job duties as assigned.

Education/Experience

  • Educated as a CMA, LPN or RN by an approved program.

Licenses/Certificates

  • Current licensure in the state of Illinois or certification for CMA.
  • CPR certification per American Heart Association guidelines required within 30 days of hire.

Knowledge, Skills and Abilities

  • Assume accountability and responsibility for own practice and that, which is delegated.

Working Environment

  • Works in office setting during the hours the Clinic is available to patients/families.
  • Sitting vs. standing averages to 50-50%.
  • Minimal lifting requirements.  Occasional lifting required for orthopedics, geriatrics and internal medicine.

PHI/Privacy Level

HIPAA1

What Springfield Clinic employees say

Pay

Benefits

Hours and flexibility

Workplace

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