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Prior Authorization Rn Jobs in Pennsylvania (NOW HIRING)

Capstone Health

RN

Philadelphia, PA · On-site

$1.4K - $1.7K/wk

Registered Nurse Philadelphia, PA Specialty: Ambulatory Surgery Position Type: Travel Contract ... You'll also handle prior authorizations, refill requests, and lab orders, ensuring seamless patient ...

OSS Health

Authorization Specialist

York, PA · On-site

$17.75 - $23.50/hr

Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred. EXPERIENCE/QUALIFICATIONS: • One-year relevant experience in the medical field or in prior authorization ...

OSS Health

Authorization Specialist

York, PA

$17.75 - $23.50/hr

Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred. EXPERIENCE/QUALIFICATIONS: • One-year relevant experience in the medical field or in prior authorization ...

OSS Health

Authorization Specialist

York, PA · On-site

$17.75 - $23.50/hr

Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred. EXPERIENCE/QUALIFICATIONS: • One-year relevant experience in the medical field or in prior authorization ...

OSS Health

Authorization Specialist

York, PA · On-site

$17.75 - $23.50/hr

Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred. EXPERIENCE/QUALIFICATIONS: One-year relevant experience in the medical field or in prior authorization required.

Jefferson

Authorization Representative

Abington, PA · On-site

$16.50 - $21/hr

Monitors work queues and patient schedules to ensure accurate authorization are in place prior to each visit. * Maintains compliance with benchmark metrics for accounts registered versus scheduled ...

Excela Health

REGISTERED NURSE RN

Greensburg, PA · On-site

The RN coordinates, directs, and actively participates as an effective member of the ... Obtains prior authorizations and/or assists with indigent programs per physician order based on the ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Pennsylvania

Prior Authorization Rn information

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$42

$72

How much do prior authorization rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for prior authorization rn in Pennsylvania is $42.35, according to ZipRecruiter salary data. Most workers in this role earn between $31.59 and $50.10 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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Cities in Pennsylvania with the most Prior Authorization Rn job openings:

Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Pennsylvania as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 20% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $88,079 per year, or $42.3 per hour.

Registered Nurse (RN) - Clinical Coordinator (No Bedside)

Serva Health LLC

Philadelphia, PA • On-site

$80K - $100K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Looking to transition away from bedside nursing?

Serva Health is hiring Registered Nurses for an in-office Clinical Coordinator role supporting patients prescribed specialty medications. This role focuses on patient education, care coordination, and telephonic support — no bedside care.

You’ll work closely with patients, caregivers, providers, payers, and specialty pharmacies to help patients access therapy and navigate their treatment journey. This is an ideal opportunity for nurses looking to move into patient services, care coordination, and clinical program support.

Responsibilities

  • Provide telephonic and digital support to patients and caregivers
  • Educate patients on prescribed therapies and treatment plans
  • Guide patients through insurance, prior authorizations, and medication access
  • Coordinate with healthcare providers, specialty pharmacies, and payers
  • Follow clinical protocols, scripts, and compliance guidelines
  • Identify and escalate Adverse Events (AEs) per SOPs
  • Document all patient interactions in CRM/EMR systems
  • Collaborate with a structured, team-based office environment

Requirements

  • Active RN license (any U.S. state)
  • Bachelor’s Degree (required)
  • 3+ years of clinical experience (RN, LPN, CNA, MA, or direct patient care)
  • Strong ability to explain medical information clearly to patients
  • Comfortable with computers, systems, and documentation
  • Ability to work onsite in Mount Laurel, NJ (required)
  • Availability for an 8-hour shift between 8AM–8PM EST (M–F)

Strongly Preferred

  • Non-bedside or telephonic nursing experience
  • Experience with insurance/reimbursement (prior authorizations, specialty meds)
  • Background supporting chronic or specialty disease patients
  • Case management or care coordination experience

We Offer:

  • Competitive Compensation structure!
  • No bedside care
  • No weekends!
  • Structured Monday–Friday schedule
  • Exposure to specialty medications & patient support programs
  • Clear path into clinical program operations & leadership
  • Comprehensive benefits package:
    • Health insurance
    • Dental insurance
    • Vision insurance
    • Life insurance
    • Paid time off
    • 401(k)
    • 401(k) matching
  • Relocation assistance
  • Employee discounts
  • Collaborative clinical team environment

Apply Today!

Company Description

Serva Health provides high-touch Patient Services programs to pharmaceutical and healthcare organizations. Our registered nurses support patient journeys across specialty pharmacy, case management, patient education, clinical trials, EMR support, and commercial therapy programs.