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Prior Authorization Rn Jobs in Mississippi (NOW HIRING)

Winston Medical Center

RN - Clinic

Louisville, MS · On-site

The Registered Nurse's role will include but will not be limited to: assessment, planning ... Sets up patient referrals and obtains prior authorizations as required by the patient's insurance ...

Washington University of St. Louis

... prior authorizations, medication refills, and treatment coordination. This role offers a highly ... Associate Degree In Nursing Or Diploma In Registered Nursing Certifications /Professional Licenses

Progressive Health

Registered Nurse

Canton, MS · On-site

CPR/AED/BLS (basic life support) certification or the ability to obtain it prior to start of ... This position requires candidates to be authorized to work in the United States on a full-time ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Mississippi

Prior Authorization Rn information

See Mississippi salary details

$7

$40

$68

How much do prior authorization rn jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for prior authorization rn in Mississippi is $40.01, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $47.36 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 Mississippi as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $83,217 per year, or $40 per hour.

LPN / RN - SCC GENERAL SURGERY

South Central Regional Medical Center

Laurel, MS • On-site

$23.50 - $32/hr

Full-time

Posted 2 days ago

New

South Central Regional Medical Center rating

5.3

Company rating: 5.3 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

964th of 1,065 rated hospitals

Job description

Job Title

Licensed Practical Nurse (LPN) / Registered Nurse (RN)

Department

SCC General Surgery

Full Time/PRN

Full Time

Job Summary

The LPN/RN is a critical member of the general surgery team, responsible for delivering patient care, managing authorization processes for advanced imaging, procedures, and surgeries, and performing peer-to-peer reviews with insurance companies to appeal and reverse denials. This role ensures seamless coordination between patients, providers, and external facilities while upholding high standards of nursing care.

Minimum Qualifications

  • Graduate of an accredited nursing program.
  • Current unrestricted LPN or RN license in Mississippi.
  • BLS certificationrequired.
  • Minimum of three years of clinical nursing experience.

Preferred Qualifications

  • Previousexperience with prior authorizations, appeals, and peer-to-peer reviewsstronglypreferred.

Essential Duties & Responsibilities

  • Obtain andsubmitprior authorizations for surgeries and advanced imagingstudiesincluding MRIs and CT scans.
  • Perform peer-to-peer reviews with insurance companies to appeal and reverse denials.
  • Maintainaccuratedocumentation of authorization requests, approvals, and appeals in the EMR.
  • Perform patient assessments including vital signs and pain evaluations.
  • Educate patientsregardingconditions, procedures, and recovery expectations.
  • Assistproviders with wound care, suture removal, and other office procedures.
  • Serve as a liaison between patients, providers, insurance companies, and external facilities.
  • Maintain organized records of authorizations, appeals, and approvals for compliance and reporting purposes.
  • Adhere to clinic policies, infection control standards, and HIPAA regulations.
  • Maintain current certifications andparticipatein ongoing education.

Professional Responsibilities

  • Demonstrate strong organizational and time management skills.
  • Communicate effectively with patients, providers, and insurance representatives.
  • Advocate for patients during authorization andappealsprocesses.
  • Utilize EMR systems and prior authorization platforms effectively.
  • Maintain compliance with organizational policies and regulatory requirements.

Physical Requirements

  • Occasional lifting of medical equipment or supplies up to 25 pounds.
  • Ability to multitask in a fast-paced clinical environment.
  • Frequent standing, walking, patient interaction, and computer use.

All candidates must be able to perform the essential functions of this position. The Americans with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to help perform the essential functions of the position.

South Central Regional Medical Center is an equal opportunity employer and does not discriminate based on race, color, religion, sex, gender, national origin, age, disability, or genetic information.

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