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Prior Authorization Rn Jobs in Florida (NOW HIRING)

Fabergent

Clinical Care Reviewer

Doral, FL

Current FL RN licensure Registered Nurse graduated from an accredited Diploma, Associates Degree or ... ER, ICU) Experience with Utilization Review and/or Prior Authorization Familiar with Interqual ...

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How much do prior authorization rn jobs pay per hour?

As of May 29, 2026, the average hourly pay for prior authorization rn in Florida is $31.57, according to ZipRecruiter salary data. Most workers in this role earn between $23.51 and $37.36 per hour, depending on experience, location, and employer.

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 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 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.

More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in Florida? The most popular types of Prior Authorization Rn jobs in Florida are:
What are popular job titles related to Prior Authorization Rn jobs in Florida? For Prior Authorization Rn jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Florida look for? The top searched job categories for Prior Authorization Rn jobs in Florida are:
What cities in Florida are hiring for Prior Authorization Rn jobs? Cities in Florida with the most Prior Authorization Rn job openings:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Florida as of May 2026, with employment types broken down into 2% As Needed, 55% Full Time, 39% Part Time, and 4% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution, with an average salary of $65,663 per year, or $31.6 per hour.
Registered Nurse Specialist - ACU | Digestive Disease Specialists - Nephrology | Day Shift | Full...

Registered Nurse Specialist - ACU | Digestive Disease Specialists - Nephrology | Day Shift | Full...

UF Health

Gainesville, FL • On-site

Full-time

Posted 10 days ago

Job description

Overview
The Advanced GI Registered Nurse (RN) selected will be located in the Digestive Disease Specialist clinic in North Tower, Shands Hospital. The position will provide clinical nursing assessment, act as patient care advocate, provide support, counseling and education to patients in the specialized area of advanced endoscopy, and will be responsible for patient case management for these specialized procedures. This position will specialize in prior authorizations and coordinates insurance approval for gastrointestinal procedures, medications, and diagnostic testing. The RN reviews medical records, verifies clinical documentation, and submits prior authorization requests to insurance providers to ensure medical necessity and compliance with payer guidelines. The RN will collaborate closely with gastroenterologists, clinical staff, and insurance representatives to obtain timely approvals, minimize delays in patient care, and address denials or appeals when necessary. The role also includes maintaining accurate documentation, educating patients about authorization requirements, and supporting efficient workflow within the gastroenterology practice.
Registered Nurse will possess specialized knowledge and skills to provide patient-centric care to patients in a physician's office setting. Will provide clinical nursing assessment, act as patient care advocate, provide support, counseling and education to patients. Will be responsible for patient case management and/or perform specialized procedures. Will work in collaboration with other health care providers and ancillary services. Will direct clinical staff and maintain mandatory regulatory institutional policy and procedures under the direction of the Manager/Medical Director. May be required to float to other UFHP practices, as needed, for staffing.
Qualifications
Minimum Education and Experience Requirements:
  • Graduate of an accredited School of Nursing.
  • One year of specialty experience or two years of ambulatory care or hospital based experience \ preferred.
  • Current licensure by the State of Florida as a Registered Nurse.
  • Certification in area of specialty preferred.
  • Proven ability to multitask, problem solve, and be a team player is essential.
  • Outstanding patient/customer service skills, verbal clarity, exceptional cognitive abilities, team focus, and problem solving skills are required for the ideal candidate.

Motor Vehicle Operator Designation:
Employees in this position: Will not operate vehicles for an assigned business purpose.
Licensure/Certification/Registration:
  • Current licensure by the State of Florida as a Registered Nurse.
  • Basic Life Support certification required or obtained within the first month of employment. BLS certification must be obtained through AHA or Red Cross.

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