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Prior Authorization Rn Jobs (NOW HIRING)

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

RN Prior Authorization

$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 ...

Sarah Bush Lincoln

RN Prior Authorization

$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 ...

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 ...

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 ...

Arizona Priority Care

Prior Auth RN

Chandler, AZ

The Prior Authorization Registered Nurse (RN) is responsible for conducting initial clinical reviews of preservice authorization requests, focusing on continuity of care and the proper utilization of ...

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How much do prior authorization rn jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for prior authorization rn 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 is a Prior Authorization RN?

A Prior Authorization RN is a registered nurse who specializes in reviewing and processing prior authorization requests for medical procedures, medications, or treatments. They evaluate clinical documentation to determine if requests meet insurance or regulatory criteria and often serve as a liaison between healthcare providers, patients, and insurance companies. Their role helps ensure that care is medically necessary and covered by the patient's health plan, streamlining access to important healthcare services while controlling costs.

What does a Prior Authorization RN do?

A prior authorization RN is a registered nurse who assesses applications for specific treatments, medical procedures, and medications. In this job, you review each request for medical coverage and determine the necessity or potential benefits of the treatment or medicine. You assess patient information and other factors to decide whether or not to authorize coverage. Your duties as a prior authorization RN also include reviewing denials of benefits and seeking additional information that could alter the initial decision. You document your findings for each case and present the evidence along with your decision. It is your job to review the case for each patient thoroughly while following all government regulations and healthcare provider policies.

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

To thrive as a Prior Authorization RN, you need a current RN license, strong clinical assessment skills, and a solid understanding of insurance guidelines and medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and payer-specific authorization systems is essential. Exceptional attention to detail, critical thinking, and effective communication help you advocate for patients and collaborate with healthcare providers and insurers. These skills ensure the efficient processing of authorizations, reduce delays in care, and support patients in receiving appropriate treatments.

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

Prior Authorization RNs often navigate complex insurance guidelines and manage high volumes of requests, which can be challenging due to frequent policy updates and tight timelines. Staying organized, maintaining up-to-date knowledge of payer requirements, and leveraging electronic health record (EHR) systems can help streamline the process. Collaboration with providers and insurance representatives, as well as ongoing training, are essential for efficiently resolving issues and ensuring timely patient care.

What is the difference between Prior Authorization Rn vs Medical Coder?

AspectPrior Authorization RnMedical Coder
CredentialsRN license, possibly certifications in case management or utilization reviewCertification in coding (CPC, CCS), no RN license required
Work EnvironmentHospitals, insurance companies, healthcare facilitiesMedical offices, hospitals, insurance companies
Primary ResponsibilitiesReviewing and obtaining prior authorizations for treatments and proceduresTranslating medical records into coded data for billing and documentation

While both roles are integral to healthcare administration, the Prior Authorization RN focuses on obtaining approvals for patient care, requiring nursing credentials and clinical knowledge. In contrast, Medical Coders specialize in coding medical records for billing, emphasizing coding certifications. Understanding these differences helps healthcare professionals and job seekers identify the right career path or job opportunity.

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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $87,868 per year, or $42.2 per hour.

Prior Authorization RN

Manhattan, NY • On-site

RCM Health Care Services
Recruiting and Staffing Services • 1 - 5K employees
Learn more about RCM Health Care Servicesexternal

$90K - $108K/yr

Other

Re-posted 29 days ago

Job description

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.

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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