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Prior Authorization Registered Nurse Jobs (NOW HIRING)

Sarah Bush Lincoln

RN Prior Authorization

$27.68/hr

RN Prior Authorization Prior Authorization RN is responsible to obtain prior authorization for medications and/or procedures when required by the patient's health insurance company. The RN routinely ...

New

RCM Health Care Services

Prior Authorization RN

$90K - $108K/yr

Pre-Authorization RN Compensation Salary Range: $90,000 - $108,000 per year Bonus / Commission (if ... Experience in prior authorization or utilization review processes * Excellent clinical judgment ...

Sarahbush

$27.68/hr

Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding. RN Prior Authorization Prior Authorization RN is responsible to obtain prior authorization for ...

New

Humana

Prior Authorization RN - Outpatient

The Prior Authorization Review Nurse works closely with healthcare providers, interdisciplinary ... Licensed Registered Nurse (RN) in Illinois, with no disciplinary action (or willing to obtain ...

Care Navigators On Demand

$39 - $45/hr

Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of ...

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Prior Authorization Registered Nurse information

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$72

How much do prior authorization registered nurse jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for prior authorization registered nurse in the United States is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $50.00 per hour, depending on experience, location, and employer.

What are some common challenges faced by a Prior Authorization Registered Nurse, and how can they be addressed?

Prior Authorization Registered Nurses often encounter challenges such as navigating complex insurance guidelines, managing high volumes of requests, and ensuring timely approvals for patient care. To address these challenges, strong organizational skills, attention to detail, and effective communication with insurance companies and healthcare providers are essential. Many nurses also rely on electronic health record systems and standardized workflows to streamline processes and reduce delays, which helps maintain patient satisfaction and supports efficient team collaboration.

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

To thrive as a Prior Authorization Registered Nurse, you need a solid clinical background, strong knowledge of insurance guidelines, and a current RN license. Familiarity with authorization management systems, electronic health records (EHRs), and payer-specific software is typically required. Attention to detail, effective communication, and critical thinking are important soft skills for reviewing cases and collaborating with providers and insurers. These skills ensure accurate, timely authorization decisions, enhanced patient access to care, and compliance with regulatory standards.

What does a Prior Authorization Registered Nurse do?

A Prior Authorization Registered Nurse is responsible for reviewing healthcare service requests to determine if they meet the necessary criteria for insurance coverage before treatment is provided. This nurse works closely with physicians, insurance companies, and patients to ensure that required medical procedures, medications, or treatments are approved in advance. Their role involves interpreting clinical information, applying insurance guidelines, and assisting with documentation to facilitate timely patient care. They help prevent unnecessary delays and reduce denied claims by ensuring all required information is submitted for approval.

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

AspectPrior Authorization Registered NurseUtilization Review Nurse
CredentialsRN license, certifications in case management or healthcareRN license, certifications in utilization review or case management
Work EnvironmentInsurance companies, healthcare providers, or managed care organizationsHospitals, insurance companies, or healthcare organizations
Job FocusReviewing and approving prior authorization requests for procedures and treatmentsAssessing medical necessity and reviewing patient records for ongoing care
Common UsageUsed in insurance and healthcare settings for authorization processesUsed in utilization management to ensure appropriate care

The main difference is that Prior Authorization Registered Nurses primarily review and approve requests for specific procedures before treatment, while Utilization Review Nurses evaluate ongoing patient care to determine medical necessity. Both roles require RN licensure and related certifications, but their focus and work settings differ slightly.

More about Prior Authorization Registered Nurse jobs
What cities are hiring for Prior Authorization Registered Nurse jobs? Cities with the most Prior Authorization Registered Nurse job openings:
What states have the most Prior Authorization Registered Nurse jobs? States with the most job openings for Prior Authorization Registered Nurse jobs include:
What job categories do people searching Prior Authorization Registered Nurse jobs look for? The top searched job categories for Prior Authorization Registered Nurse jobs are:
Prior Authorization Registered Nurse jobs near you
Infographic showing various Prior Authorization Registered Nurse job openings in the United States as of August 2026, with employment types broken down into 74% Full Time, and 26% Part Time. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $87,868 per year, or $42.2 per hour.

RN Prior Authorization

Sarah Bush Lincoln

Remote

$27.68/hr

Other

Posted 2 days ago

New

Sarah Bush Lincoln rating

7.7

Company rating: 7.7 out of 10

Based on 43 frontline employees who took The Breakroom Quiz

159th of 887 rated healthcare providers

Job description

RN Prior Authorization

Prior Authorization RN is responsible to obtain prior authorization for medications and/or procedures when required by the patient's health insurance company. The RN routinely communicates and collaborates with patients, insurance companies, other departments, and healthcare providers.

Hours: Full-time/40 hours per week

Required: RN; ADN

Pay: Based on experience, starting at $27.68 per hour

Responsibilities

  • Assists with other tasks to support patients or team members.
  • Documents results of authorization approval/denial in the patient chart.
  • Maintains up-to-date knowledge of new medications/procedures and diagnoses for which the treatment is effective.
  • Notifies the ordering healthcare provider and patient if authorization is denied and works to help resolve the denial in an effort to gain approval.
  • Obtains current patient demographics and insurance benefits from Registration.
  • Requests authorization after medications / procedures have been provided when needed.
  • Responsible for contacting patients' insurance companies to obtain prior authorization (if required) for medications and/or procedures ordered by the healthcare provider.
  • Serves as a customer service representative and liaison among patient, insurance company, and medical staff.
  • Works closely with the healthcare provider's office nurse to ensure proper authorization is obtained. Collects insurance benefit information, sends supporting medical records, and provides benefits of medication and/or procedures ordered.

Requirements

  • ADN (Required)
  • RN-Registered Nurse - Illinois Department of Financial and Professional Regulation

Compensation

Estimated Compensation Range

$27.68 - $42.90

Pay based on experience

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Benefits

Hours and flexibility

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