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Prior Authorization Rn Jobs in New York (NOW HIRING)

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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Prior Authorization Rn information

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$8

$46

$78

How much do prior authorization rn jobs pay per hour?

As of Sep 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 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 New York as of September 2026, with employment types broken down into 74% Full Time, 21% Part Time, and 5% Contract. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $96,130 per year, or $46.2 per hour.

Registered Nurse

Manhattan, NY • On-site

Emma L Bowen Community Service Center
See more jobs at Emma L Bowen Community Service Centerexternal

$95K - $110K/yr

Full-time

Posted 23 days ago

Job description

The Registered Nurse (RN) provides comprehensive nursing care and clinical support to individuals and families across the organization’s behavioral health programs, including therapeutic preschool, early childhood program, school-based services, child and adolescent services, adult outpatient services, and addiction treatment services. The RN works collaboratively with an interdisciplinary team to promote client safety, wellness, treatment engagement, and continuity of care across the lifespan.

Essential Responsibilities

  • Conduct nursing assessments and monitor clients for changes in physical health, mental health, behavior, and substance use. This includes obtaining vital signs. 

  • Assess for safety concerns, including suicidal or homicidal ideation, self-harm, acute psychiatric symptoms, intoxication, withdrawal, and other conditions requiring immediate intervention.

  • Provide medication education and support clients and families in understanding and safely managing medications.

  • Coordinate medication-related services, including medication reconciliation, refills, long-acting injectable medications, prior authorizations, and communication with prescribing providers as applicable.

  • Support integrated physical and behavioral healthcare by identifying medical concerns, promoting preventive care, and coordinating with primary care and other medical providers.

  • Participate in interdisciplinary treatment planning and communicate relevant clinical information to psychiatrists, psychiatric NPs, therapists, social workers, case managers, school personnel, and other members of the care team.

  • Respond to medical and psychiatric emergencies and assist in determining the appropriate level of care, including coordination with emergency services, hospitals, primary care providers, and other community resources.

  • Provide appropriate follow-up and care coordination following emergency department visits, hospitalizations, or other transitions in care.

  • Assess and support individuals receiving addiction treatment, including monitoring for intoxication, withdrawal, medication effects, and other substance-use-related health concerns.

  • Collaborate with families, caregivers, schools, and community providers as appropriate to support continuity and safety of care.

  • Maintain accurate, timely, and clinically appropriate documentation in accordance with organizational policies and applicable regulatory requirements.

  • Maintain professional nursing standards, licensure, competencies, and required continuing education.