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Prior Authorization Rn Jobs in Georgia (NOW HIRING)

SouthCoast Health

RN-Sign on Bonus

Savannah, GA · On-site

SouthCoast is Looking for a Full-Time RN For Our Outpatient Cardiology Department Sign-on Bonus $1 ... prior authorizations, medication refills, and post-visit follow-ups Participate in quality ...

SouthCoast Health

RN-Sign on Bonus

Savannah, GA · On-site

RN-Sign on Bonus (Full Time) Department: Cardiology Location: 1326 Eisenhower Drive, Savannah, GA ... Manage prior authorizations, medication refills, and post-visit follow-ups * Participate in quality ...

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How much do prior authorization rn jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for prior authorization rn in Georgia is $35.67, according to ZipRecruiter salary data. Most workers in this role earn between $26.59 and $42.21 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 Georgia as of September 2026, with employment types broken down into 85% Full Time, and 15% Part Time. Highlights an 100% In-person job distribution, with an average salary of $74,194 per year, or $35.7 per hour.

D186 - Jail Services - Registered Nurse

Macon, GA • On-site

River Edge
See more jobs at River Edgeexternal

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Job description

Posted Wednesday, August 12, 2026 at 4:00 AM

About River Edge Behavioral Health

Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.

Company Overview:

At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.

Program Overview:

River Edge is currently seeking a Full-time Registered Nurse for the Judiciary In-reach Program. Under the supervision of the Nurse Practitioner, the Registered Nurse provides direct nursing care by conducting patient assessments, administering and monitoring medications, collecting laboratory specimens, observing and reporting changes in patient condition, and maintaining medication control. The Registered Nurse also educates patients on symptoms and treatments, assists with patient assistance applications and prior authorizations, accurate documents all care provided at the Bibb County Jail.

Duties & Responsibilities
  • Completes nursing assessments, including food/nutrition and pain assessments.
  • Administers and monitors medication management regimens.
  • Administers prescribed medications, making constant adjustments commensurate with a patient's condition under the supervision of qualified medical staff.
  • Observes and reports behavioral changes.
  • Maintains control of drugs and medications
  • Collect urine samples and blood draws to submit to the lab for testing.
  • Provide symptoms and treatment education to patients.
  • Assist in completing patient assistance applications and prior authorizations as needed.
  • Records all care information concisely, accurately, and completely, in a timely manner, in the appropriate format and in the appropriate forms.
  • Performs other position‑related duties as assigned, depending on assignment setting.
  • Remain in compliance with internal and external policies, procedures, regulations, and standards, including all of River Edge's policies and procedures and Quality Assurance Plan, DBHDD requirements, State Licensing standards, County Monitoring requirements, and managed care regulations.
Qualifications
  • Current nursing license, in good standing with the Georgia State licensing board
  • Minimum of one (1) year Psychiatric experience.
  • All applicants must pass a satisfactory background clearance and pre-employment drug test.
  • Provide 2 Professional references (Former employers only, no family members)
  • Must have knowledge and experience with the chronically mentally ill population.
Additional Benefits:
  • Flexible spending accounts
  • Short and long-term disability coverage
  • 11 Paid holidays
  • Voluntary Life Insurance

We are an equal opportunity employer and highly value diversity.We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

All selected applicants must pass a satisfactory background clearance and pre-employment drug test.

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