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Prior Authorization Rn Jobs in Michigan (NOW HIRING)

Trinity Health - IHA

RN

Pontiac, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · Hybrid

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN - Primary Care

Ann Arbor, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Chelsea, MI

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health

RN

Pontiac, MI

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Chelsea, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Plymouth, MI

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ann Arbor, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Brighton, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ypsilanti, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Brighton, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

Trinity Health - IHA

RN

Ann Arbor, MI · On-site

The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work ...

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Prior Authorization Rn information

See Michigan salary details

$6

$36

$62

How much do prior authorization rn jobs pay per hour?

As of May 30, 2026, the average hourly pay for prior authorization rn in Michigan is $36.82, according to ZipRecruiter salary data. Most workers in this role earn between $27.45 and $43.56 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 Michigan? The most popular types of Prior Authorization Rn jobs in Michigan are:
What are popular job titles related to Prior Authorization Rn jobs in Michigan? For Prior Authorization Rn jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Michigan look for? The top searched job categories for Prior Authorization Rn jobs in Michigan are:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Michigan as of May 2026, with employment types broken down into 80% Full Time, 10% Part Time, and 10% Contract. Highlights an 100% In-person job distribution, with an average salary of $76,585 per year, or $36.8 per hour.

RN

Trinity Health - IHA

Pontiac, MI • On-site

Full-time

Posted 18 days ago

Job description

POSITION DESCRIPTION:
Provides professional nursing care for patients following established standards and practices, which can include triage (telephone and walk-in visits), and care needs that transpire between office visits. The position ensures timely access to appropriate services, reduces care fragmentation, and promotes optimal health outcomes and patient safety. Demonstrates professional clinical leadership and oversight within the scope of the RN role.
ESSENTIAL JOB FUNCTIONS:
The following job functions may not be the responsibility of all RN's. Some RN's will be assigned work that has more focused responsibilities (example: prior authorizations or indirect work supporting a provider inbox.)
  1. Responsible for efficiently triaging patient needs via telephone and during visits to ensure appropriate timely access to the appropriate level of care, reducing avoidable emergency department visits and readmissions according to IHA's Policies and Protocols.
  2. Conducts post-discharge calls for patients experiencing a transition of care for identified populations.
  3. Documents clinical findings in a clear and concise manner according to IHA Policy.
  4. Utilizes critical thinking skills within the scope of licensure to appropriately assess patient needs and involves providers as appropriate.
  5. Enters orders (medication, laboratory, radiology, referrals) according to provider direction and as per state, local and professional guidelines.
  6. Follows clinical and nursing protocols as applicable.
  7. Schedules patient appointments as applicable.
  8. Encourages patient portal usage and supports where needed.
  9. Provides scope-appropriate nursing education during all patient interactions.
  10. Consults with providers and other extended care team members (Care Management, Embedded Pharmacy, Behavioral Health and Nutrition) and external case managers as appropriate to effectively ensure quality patient care.
  11. Supports physician and advanced practice providers with indirect work according to protocol. This includes and is not limited to test results/orders management.
  12. Assesses patients for gaps in care for preventative and disease management needs.
  13. Ensures patient medication list is accurate, completes medication reconciliation and processes refill requests per protocol.
  14. Works with the entire care team to co-manage indirect patient work according to Standard Work Instructions.
  15. Collaborates with insurance, DME, home care and all other care partners to ensure patient needs are met.
  16. Reviews patient medical history to identify supporting documentation relevant to ordered services and procedures to assist with or complete prior authorization process.
  17. Assists patients with resources for any social influences of health needs.
  18. Participates in process improvement projects within the office/department.
  19. Serves as a resource to clinical office/department staff within scope of RN role; may direct the work of LPN and Medical Assistant staff as needed and appropriate based on role/scope.
  20. May perform clinical support tasks as outlined on the Clinical Support Staff Scope of Practice document.
  21. Supports other offices, attends required meetings and training, and participates in committees as requested.
  22. Attends weekly patient care meetings and attends daily huddles as applicable.
  23. Assumes additional duties as required.

ORGANIZATIONAL EXPECTATIONS:
  1. Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the mission and values of Trinity Health Medical Group.
  2. Must be able to work effectively as a member of the clinical care team.
  3. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
  4. Successfully completes all relevant organizational training and adheres to Trinity Health Medical Group standard of care as outlined in the Trinity Health Code of Conduct.
  5. Maintains knowledge of and complies with Trinity Health Medical Group standards, policies and procedures.
  6. Maintains general knowledge of Trinity Health Medical Group office services and in the use of all relevant office equipment, computer and manual systems.
  7. Maintains strict confidentiality in compliance with Trinity Health Medical Group and HIPAA guidelines.
  8. Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences.
  9. Uses resources efficiently.
  10. If applicable, responsible for ongoing professional development - maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:
Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.
ESSENTIAL QUALIFICATIONS:
EDUCATION: Graduate of an accredited Registered Nurse program.
CREDENTIALS/LICENSURE: Valid, unrestricted RN license in the State of Michigan. Valid CPR certification.
MINIMUM EXPERIENCE: 1-2 years of clinical experience in a medical or physician office preferred. Previous nursing experience not required.
POSITION REQUIREMENTS (ABILITIES & SKILLS):
  1. Demonstrated competency in obtaining accurate patient vital statistics (height, weight, blood pressure, temperature, etc.) and patient health history.
  2. Must have basic knowledge and understanding as to the relevance of patient vital statistics to the patients' health history.
  3. Proficient/knowledgeable in medical terminology.
  4. Proficiency in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, email, e-learning, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.
  5. Excellent communication skills in both written and verbal forms, including proper phone etiquette.
  6. Ability to work collaboratively in a team-oriented environment; displays courteous and friendly demeanor.
  7. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, patients, vendors, family members, outside customers and community groups.
  8. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.
  9. Good organizational and time management skills to effectively juggle multiple priorities, time constraints and ever-changing medical situations.
  10. Ability to exercise sound judgement and problem-solving skills.
  11. Ability to perform mathematical calculations needed during the course of performing basic job duties, i.e.: calculating proper dosages for immunizations.
  12. Knowledge of the compliance aspects of clinical care and patient privacy and best practices in medical office operations.
  13. Ability to handle patient and organizational information in a confidential manner.
  14. Ability to travel to other office/practice sites and meeting and training locations.
  15. Successful completion of IHA competency-based program within introductory and training period.

MINIMUM PHYSICAL EXPECTATIONS:
  1. Physical activity that often requires keyboarding, phone work and charting.
  2. Physical activity that often requires time working on a computer.
  3. Physical activity that often requires lifting over 50 lbs.
  4. Physical activity that sometimes requires handling and lifting patients, transferring patients to gurney using slide board, assisting patients with dressing/undressing, transferring patients to wheelchair using gaitbelt, walking, bending, stooping, reaching, climbing, kneeling and/or twisting.
  5. Physical activity that sometimes requires lifting, pushing and/or pulling up to 100 lbs.
  6. Specific vision abilities required include close vision, depth perception, color vision, peripheral vision and the ability to adjust and focus.
  7. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
  8. Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

MINIMUM ENVIRONMENTAL EXPECTATIONS:
This job operates in a medical facility and requires regular walking to various locations around the hospital/clinic. Employees will be working where there is patient care equipment. Hazardous materials, including bloodborne pathogens and bodily fluids are also present. Exposure to sharps, x-rays, patients' conditions and some unpleasant sights, smells and contagious diseases are possible. This position requires significant interaction with people (many of whom are scared, hurt and/or ill) which can be stressful and result in competing priorities.

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