Waltham, MA · On-site
$30/hr
Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company?
Waltham, MA · On-site
$30/hr
Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company?
Cambridge, MA · Remote
$63.25 - $76/hr
Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Cambridge, MA · Remote
$63.25 - $76/hr
Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Boston, MA · Remote
$63.25 - $76/hr
Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Boston, MA · Remote
$63.25 - $76/hr
Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... Imaging and Prior Authorization Team Leader is a critical position within the Referral Department ...
Boston, MA · On-site
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... Unrestricted RN license required in the state of Massachusetts * 3+ years of Managed Care and/or ...
Boston, MA · On-site
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... Unrestricted RN license required in the state of Massachusetts * 3+ years of Managed Care and/or ...
$26.75 - $36.25/hr
Registered Nurse (RN) Or Licensed Practical Nurse (LPN) $5,000 sign-on bonus for full-time RN or ... prior authorization, med refills, triage call and voicemails; conduct ambulatory nurse visits ...
$26.75 - $36.25/hr
Registered Nurse (RN) Or Licensed Practical Nurse (LPN) $5,000 sign-on bonus for full-time RN or ... prior authorization, med refills, triage call and voicemails; conduct ambulatory nurse visits ...
Boston, MA · Remote
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... Unrestricted RN license required in the state of Massachusetts * 3 years of Managed Care and/or ...
Boston, MA · Remote
$28.94 - $51.83/hr
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical ... Unrestricted RN license required in the state of Massachusetts * 3 years of Managed Care and/or ...
$18.50 - $22.50/hr
... through prior authorizations. Working with patients and a variety of funding sources such as ... We are seeking experienced pharmacy technicians who are state registered, or state certified as a ...
Quick apply
$18.50 - $22.50/hr
... through prior authorizations. Working with patients and a variety of funding sources such as ... We are seeking experienced pharmacy technicians who are state registered, or state certified as a ...
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
Holyoke, MA · On-site
$34.33 - $53.81/hr
$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...
Worcester, MA · On-site
$18.50 - $23/hr
Under the direction of the Manager of Prior Authorization, communicates with contracted and non ... Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. * Handles an ...
Worcester, MA · On-site
$18.50 - $23/hr
Under the direction of the Manager of Prior Authorization, communicates with contracted and non ... Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. * Handles an ...
$18.50 - $23/hr
Under the direction of the Manager of Prior Authorization, communicates with contracted and non ... Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. * Handles an ...
$18.50 - $23/hr
Under the direction of the Manager of Prior Authorization, communicates with contracted and non ... Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. * Handles an ...
Northampton, MA · On-site
$32/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Northampton, MA · On-site
$32/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Northampton, MA · On-site
$32 - $38/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Quick apply
Northampton, MA · On-site
$32 - $38/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Northampton, MA · On-site
$32 - $38/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Quick apply
Northampton, MA · On-site
$32 - $38/hr
... and prior authorizations, and maintains accurate clinical records. Working collaboratively within a multidisciplinary treatment team, the RN plays a critical role in care coordination, client ...
Busy Primary Care practice - Seabrook, NH RN will be administrative, triaging calls, prior authorizations, some patient care, patient education NH RN License & BLS required. BILH Coversheet Required ...
Quick apply
Busy Primary Care practice - Seabrook, NH RN will be administrative, triaging calls, prior authorizations, some patient care, patient education NH RN License & BLS required. BILH Coversheet Required ...
Needham, MA · On-site
TravelDescription / Comment :RN - Chestnut Hill Internal Medicine-In Chestnut Hill MA- 40 hrs M-F- 8:30a-5p Busy Primary Care practice RN will be administrative, triaging calls, prior authorizations ...
Quick apply
Needham, MA · On-site
TravelDescription / Comment :RN - Chestnut Hill Internal Medicine-In Chestnut Hill MA- 40 hrs M-F- 8:30a-5p Busy Primary Care practice RN will be administrative, triaging calls, prior authorizations ...
As a VA RN, you will play a vital role in assessing, planning, implementing, and evaluating nursing ... Not Authorized
As a VA RN, you will play a vital role in assessing, planning, implementing, and evaluating nursing ... Not Authorized
$8.14 - $14.56
0% of jobs
$14.56 - $20.98
0% of jobs
$20.98 - $27.40
4% of jobs
$27.40 - $33.82
18% of jobs
$34.66 is the 25th percentile. Wages below this are outliers.
$33.82 - $40.24
20% of jobs
The median wage is $42.88 / hr.
$40.24 - $46.66
18% of jobs
$52.44 is the 75th percentile. Wages above this are outliers.
$46.66 - $53.08
16% of jobs
$53.08 - $59.50
10% of jobs
$59.50 - $65.92
6% of jobs
$65.92 - $72.34
4% of jobs
$72.34 - $78.76
3% of jobs
$8
$46
$78
| Aspect | Prior Authorization Rn | Medical Coder |
|---|---|---|
| Credentials | RN license, possibly certifications in case management or utilization review | Certification in coding (CPC, CCS), no RN license required |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Medical offices, hospitals, insurance companies |
| Primary Responsibilities | Reviewing and obtaining prior authorizations for treatments and procedures | Translating 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.
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.
$30/hr
Full-time
Medical, Dental, Vision
Posted 3 hours ago
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Are you an experienced RN Prior Authorization looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
Daily Responsibilities: Â
Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.
Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care
Educate providers on utilization and medical management processes
Hours for this Position:
Monday- Friday; 8AM-5PM
Pay rate starts at $30 per hour
Advantages of this Opportunity:Â
Competitive salary, negotiable based on relevant experience
Benefits offered, Medical, Dental, and Vision
Fun and positive work environment
RN licensure
Candidates must have a car- mass transportation in Boston doesn't go to Waltham
2+ years of clinical nursing experience
Some sort of Prior Authorization experience from either another managed care company or clinical setting
Interested in being considered?Â
If you are interested in applying to this position, please contact (Katleen Angala, 321-445-8243) and click the Green I'm Interested Button to email your resume.Â
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003
