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Prior Authorization Rn Jobs in Kentucky (NOW HIRING)

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Prior experience in long-term care preferred but not required. * A Nursing degree from an accredited college or university. * Current unrestricted license as a Registered Nurse (RN) in practicing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Prior experience in long-term care preferred but not required. * A Nursing degree from an accredited college or university. * Current unrestricted license as a Registered Nurse (RN) in practicing ...

Pharmacy Care Coordinator

La Grange, KY · On-site

$17.75 - $23.25/hr

Supports third party prior authorization process and obtain appropriate overrides for new patients ... Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses ...

Pharmacy Care Coordinator II

La Grange, KY

$17.75 - $23.25/hr

Supports third party prior authorization process and obtain appropriate overrides for new patients ... Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses ...

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Prior Authorization Rn information

See Kentucky salary details

$6

$36

$62

How much do prior authorization rn jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for prior authorization rn in Kentucky is $36.69, according to ZipRecruiter salary data. Most workers in this role earn between $27.36 and $43.41 per hour, depending on experience, location, and employer.

How to make $300,000 a year as a nurse?

A Prior Authorization RN can earn $300,000 annually by gaining extensive experience, obtaining advanced certifications, and working in high-paying settings such as specialty clinics or insurance companies. Increasing workload, taking on leadership roles, or working overtime can also boost income, but reaching this level typically requires a combination of expertise, efficiency, and strategic employment choices.

How to make 150,000 as a nurse?

A Prior Authorization RN can earn $150,000 by gaining extensive experience, obtaining relevant certifications, and working in high-paying settings such as specialty clinics or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting opportunities can also increase earning potential.

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.

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 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 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.

Can nurses do prior authorizations?

Prior authorization nurses, often called utilization review nurses or case managers, are qualified to handle prior authorization requests. They review medical documentation, communicate with providers and insurance companies, and ensure compliance with payer requirements, often using electronic health record systems. Certification in case management or utilization review can enhance their ability to perform these tasks effectively.

How to make an extra 2000 a month as a nurse?

A Prior Authorization RN can increase income by taking on additional shifts, working overtime, or offering consulting services to healthcare providers. Developing specialized knowledge in insurance authorization processes and obtaining relevant certifications can also lead to higher-paying opportunities or freelance work outside regular hours.

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 cities in Kentucky are hiring for Prior Authorization Rn jobs? Cities in Kentucky with the most Prior Authorization Rn job openings:
Infographic showing various Prior Authorization Rn job openings in Kentucky as of June 2026, with employment types broken down into 60% Full Time, 38% Part Time, 1% Temporary, and 1% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $76,315 per year, or $36.7 per hour.
Registered Nurse-Ambulatory Surgery

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 969 frontline employees who took The Breakroom Quiz

69th of 872 rated healthcare providers


Job description

Summary Robley Rex VA Healthcare System, Louisville, Kentucky is currently recruiting for a Registered Nurse-Ambulatory Surgery Louisville, Kentucky 603. part of the time will be in Post Anesthesia Care Unit (PACU) and part of the time will be in Ambulatory Surgery Responsibilities The Ambulatory Surgery Registered Nurse (RN) provides pre-operative/procedural care, including (but not limited to) the nursing assessment of patients, consent, and H&P validations, the starting of intravenous fluids including venipuncture, assisting with peripheral nerve blocks, assuring all lab work and other pre-operative/procedural testing is completed and communicated to team members, confirms surgical sites are prepared and marked, the administration of medications as ordered, provides clear and concise preoperative teaching and reviews discharge instructions to patients and families with written and verbal communication. The Ambulatory RN monitors post-operative patient's level of consciousness after the recovery of anesthesia/sedation, closely observes signs of side effect of post residual anesthesia medications.

The Ambulatory RN maintains knowledge of current American Society of Peri Anesthesia Nurses (ASPAN) standards, VHA Directive and service level standard operating procedures. The Ambulatory RN is responsible for ensuring comprehensive documentation of all phases of care and is timely, complete, and accurate in the electronic health record. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Monday-Friday, 8:30am-5:00pm; on call required, tour could vary based on staffing needs Telework: Not available Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Pay Schedule: NF45 Requirements Conditions of Employment U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment.

Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation.

Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.

Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period.

Complete all application requirements detailed in the "Required Documents" section of this announcement. Qualifications Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C.

7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program.

(Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification. Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12979497.

Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.

An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.

An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience. Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.

Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees.

Preferred Experience: Peri-Operative environment preferred Experience in outpatient procedural area preferred Acute Care experience preferred BSN/MSN preferred Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: It is VA policy to ensure that all selected applicants and employed personnel are physically, mentally and emotionally fit to perform the duties of the position to which assigned. A pre-placement physical examination is required for all fulltime, part-time and intermittent employees identified by VA Directive and Handbook 5019.

The pre-placement physical examination shall be completed prior to appointment to determine the physical and mental fitness for candidates for appointment in VA. The examination will be concerned with the mental and physical ability of the applicant to satisfactorily perform the duties of the proposed assignment and will include requisite laboratory and other screening as required by Federal regulatory agencies. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity.

This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. This position requires that you are able to lift at least 50 lbs. Transferring patients and objects may be required.

The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on organizational needs.

Must complete annual Employee Health requirements, such as annual Influenza vaccination, TB screening or testing, as a condition of employment. Education Additional Information This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status.

VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.


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About Veterans Health Administration

Sourced by ZipRecruiter

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US