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Prior Authorization Rn Jobs in Michigan (NOW HIRING)

Oak St. Health

Registered Nurse

Hazel Park, MI Β· On-site

Registered Nurse We're building a world of health around every individual -- shaping a more ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

Oak Street Health

Registered Nurse

Hazel Park, MI Β· On-site

Registered Nurse We're building a world of health around every individual -- shaping a more ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

Christian Care

Admissions Nurse

Muskegon, MI Β· On-site

Required Qualifications An unencumbered nursing license in the state, LPN/LVN or RN. Must ... Knows, at all times, which payment entities require prior authorization for payment and secures ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Michigan

Prior Authorization Rn information

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$36

$62

How much do prior authorization rn jobs pay per hour?

As of Sep 14, 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 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.

More about Prior Authorization Rn jobs

What are the most commonly searched types of Prior Authorization Rn jobs in Michigan?

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For Prior Authorization Rn jobs in Michigan, the most frequently searched job titles are:

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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 September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, 1% Temporary, and 6% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $76,585 per year, or $36.8 per hour.

Registered Nurse (RN), Orthopedics Clinic

Hancock, MI β€’ On-site

Memorial Physician Practices
See more jobs at Memorial Physician Practicesexternal

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Job description

Registered Nurse (RN), Orthopedics Clinic

Job Type: Full-Time | 1.0 FTE or 80 hours/pp

Schedule: Monday-Friday, 8-hour Day shifts

$5,000 Sign-on Bonus *Based on meeting eligibility criteria.

Your experience matters

UP Health System - Portage is part of Lifepoint Health, a diversified healthcare delivery network. As a Clinic RN, you will provide exemplary patient care to support our community.

More about our team

At UPHS - Portage, we strive to be the place employees want to work. We accomplish this through a friendly and supportive team environment and a quality-focused nursing team.

How you'll contribute
  • Performs plan of care intervention, including medication administration, specimen collection, clinical treatments, and other medical care treatment.
  • Documents patient care given.
  • Monitors, records, and communicates patient condition as appropriate to the care team, physician, nursing home, patient, and family.
  • Collaborates across disciplines to coordinate patient care, including patient transfer, discharge, referral and spiritual/psychosocial support needs.
  • Evaluates learning needs of patient and/or family and provides patient/family education appropriate to age, culture, condition, and circumstances.
  • Works as an advocate for the physical and emotional well‑being of the patient.
  • Delegates patient care activities to appropriately qualified staff.
  • Performs prior authorizations on tests, procedures, medications, etc. that are required by the patient's insurance.
  • Performs other job duties as assigned.
Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

  • Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full‑time and part‑time employees.
  • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short‑ and long‑term disability, paid family leave and paid time off.
  • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
  • Employee Well‑being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
  • Professional Development: Ongoing learning and career advancement opportunities.
What we're looking for

Applicants should have a current Michigan RN license (or attain within 90 days of hire) and possess an associate degree from an accredited nursing school (bachelor's degree preferred). Additional requirements include:

  • Basic Life Support certification is required (available upon hire).
  • Annual Influenza Vaccination or Declination Required.

EEOC Statement

UP Health System - Portage is an Equal Opportunity Employer. UP Health System - Marquette is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

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