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Prior Authorization Rn Jobs in Rhode Island (NOW HIRING)

Medix

Registered Nurse - Family Medicine

Providence, RI · On-site

$37.50 - $45/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Support care management initiatives and assist with referrals, prior authorizations, and medication ... Active Registered Nurse (RN) license in Rhode Island * Minimum 1 year of RN experience in Family ...

Medix

Registered Nurse - Internal Medicine

Providence, RI · On-site

$37.50 - $45/hr

  • Medical

  • Dental

  • Vision

  • Retirement

... prior authorizations, and care coordination. * Document patient encounters, assessments, education ... Qualifications * Active Registered Nurse (RN) license in Rhode Island. * Minimum 1 year of RN ...

Brownhealth

Sr Referral Specialist

Providence, RI · On-site

... prior authorization processes for episode based medication referrals. Coordinates and ensures ... Documents any communication with referring providers, patients and/or Clinic (MD, RN, etc.) in the ...

Lifespan

Sr Referral Specialist

Providence, RI · On-site

... prior authorization processes for episode based medication referrals. Coordinates and ensures ... Documents any communication with referring providers, patients and/or Clinic (MD, RN, etc.) in the ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Rhode Island

Prior Authorization Rn information

See Rhode Island salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for prior authorization rn in Rhode Island is $41.37, according to ZipRecruiter salary data. Most workers in this role earn between $30.82 and $48.94 per hour, depending on experience, location, and employer.

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.

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.
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Rhode Island as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $86,050 per year, or $41.4 per hour.

Prior Authorization Licensed Practical Nurse

US Tech Solutions

Providence, RI • On-site

$26 - $35.25/hr

Other

Re-posted 21 days ago

Job description

Please note: Actual location may vary., RI

Contract

Job Summary:

This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area away from distractions, and must have their own secure private internet services of at least 25mbps download/3mbps upload in order to ensure sufficient speed to adequately perform work duties. Must provide a screenshot of internet speeds with resume and provide license number.

Responsibilities:

Responsibilities include answering inbound phone calls, processing cases and electronic authorizations, loading authorizations, and making follow-up phone calls utilizing appropriate courteous and professional behavior based upon established standards. Maintaining complete and accurate, documentation of all necessary information is necessary and will involve computer system data entry, data management, and reporting.

Experience:

  • · Review criteria-based prior authorizations following policy and procedure.

  • · Provide on-call after hours nurse availability for urgent PA requests.

  • · Provide internal nurse support to the PA team and member services department .

  • · Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).

  • · Shift priorities while exhibiting a high level of urgency with all calls and assignments.

  • · Excellent verbal and written skills.

  • · You will work with pharmacists, other clinical colleagues, healthcare professionals and members.

  • · Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.

  • · Train and mentor representatives on the PA team.

  • · Complete other PA assignments as delegated by the PA leadership team.

Education:

The Licensed Practical Nurse is a graduate of a school of Practical or Vocational Nursing, approved by the State Agency and/or accredited by the National League for Nursing (Accrediting Commission (NLNAC)) at the time the program was completed by the applicant.

Skills:

LPN, Prior auth

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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About US Tech Solutions

Sourced by ZipRecruiter

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Jersey City, NJ, US

Year founded

2000

Social media

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