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Prior Authorization Rn Jobs in New York (NOW HIRING)

Project Renewal

Registered Nurse

New York, NY · On-site

$36.40/hr

Registered Nurse Location: Clinton Residence Schedule: 28 hours per week Hourly Rate: $36.40 ... prior authorization for medications or medical supplies * Assisting with medication refills and ...

projectrenewal

Registered Nurse

New York, NY

$36.40/hr

Registered Nurse Location: Clinton Residence Schedule: 28 hours per week Hourly Rate: $36.40 ... prior authorization for medications or medical supplies * Assisting with medication refills and ...

Medix

Clinical Review RN

Jericho, NY · On-site

$50 - $53/hr

Clinical Review RN (IDR/Appeals) Experience: Open to various clinical backgrounds/experience ... They will conduct clinical level review, Prior Authorization, and disputed benefits review ...

VillageMD

Registered Nurse - Rheumatology

Clifton, NJ · On-site

Registered Nurse (RN) As a Registered Nurse (RN) at Summit Health you are a full integral partner ... Initiates and follows through with prior authorization requests, DME orders, home health referrals

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in New York

Prior Authorization Rn information

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$8

$46

$78

How much do prior authorization rn jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for prior authorization rn in New York is $46.22, according to ZipRecruiter salary data. Most workers in this role earn between $34.47 and $54.71 per hour, depending on experience, location, and employer.

What do prior authorization nurses do?

Prior authorization nurses review medical documentation and communicate with healthcare providers and insurance companies to obtain approval for specific treatments, medications, or procedures. They ensure that requests meet insurance criteria, often using electronic health records and authorization systems, to facilitate timely patient care.

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.

How to make $300,000 as a nurse?

A Prior Authorization RN can increase earnings by gaining specialized certifications, working in high-paying healthcare settings, or taking on overtime and extra shifts. Developing expertise in insurance processes and healthcare regulations can also lead to higher-paying roles or consulting opportunities.

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

A Prior Authorization RN can increase income by taking on overtime shifts, working in high-demand specialties, or obtaining certifications to qualify for higher-paying roles. Additionally, freelance consulting or remote review work can provide supplementary income 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.
More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in New York? The most popular types of Prior Authorization Rn jobs in New York are:
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What cities in New York are hiring for Prior Authorization Rn jobs? Cities in New York with the most Prior Authorization Rn job openings:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in New York as of July 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% In-person job distribution, with an average salary of $96,130 per year, or $46.2 per hour.
RN Care Team Manager - Relocate to Los Angeles, CA

RN Care Team Manager - Relocate to Los Angeles, CA

AIDS Healthcare Foundation

New York, NY

Full-time

Posted 19 days ago

AIDS Healthcare Foundation rating

8.1

Company rating: 8.1 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

A Registed Nurse Care Manager (RNCTM) contributes to AHF by satisfying the AHF Core Measure of being Patient Centered, regulatory & contractual compliance requirements and AHF’s North Star mission. The RNCTM position focuses on removing access to care/community resource barriers and improving health outcomes, as well as health equity by ensures timely case processing of grievances, including access to care & quality of care (QOC) cases, QOC Potential Quality Issue (PQI) investigations, and critical incident identification, tracking, ad monitoring. This role will also decrease the Division of Medicine (DOM) prior authorization denial rate, which also removes access to care barriers and improves AHF patient outcomes.

A RNCTM enhances the reputation of AHF by utilizing core principles of Risk Management to cultivate and facilitate essential functions for AHF patients.

You will be a passionate advocate for our top initiatives.

To be successful as a RNCTM it is crucial to ensure that the AHF Core Values and Mission stay top of mind with all that you do. At AHF we are nimble and able to adapt in a dynamic environment to assist in providing the best experience for our clients and workplace for our employees.

AHF has a collaborative organizational structure where staff are accountable to multiple leaders.

The RNCTM will work as a part of a close-knit team to ensure that day-to-day RM activities are executed in accordance with AHF policies and procedures that adhere to regulatory, contractual and accreditation requirements. This role works collaboratively with all AHF staff and ensures timely triaging and processing of grievances, PQIs, & related investigations. The RNCTM also mitigates prior authorization denials & appeals submitted by the AHF Healthcare Centers by trending common denial reasons, educating providers on documentation best practices, and promoting awareness of payer-specific requirements and updates to nursing/referral teams.

Licenses and Certifications:

CA Registered Nurse (RN) License required.

Multistate RN License within 6 months of hire required.

Managed Care experience preferred.

Grievance/Appeals/Quality Improvement experience preferred.

Bilingual Spanish preferred.


AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, AIDS Healthcare Foundation is the place for you!

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF’s core values are:

  • Patient-Centered
  • Value Employees
  • Respect for Diversity
  • Nimble
  • Fight for What’s Right

Please review our Advocacy page for the latest news on how AHF is Fighting for What’s Right! Advocacy News.

Benefits at AHF

AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance employee physical, financial, spiritual and professional health.

STILL INTERESTED? Please continue!

#INDAHF

#ZR


Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Company Description

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

What AIDS Healthcare Foundation employees say

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Benefits

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