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Prior Authorization Rn Jobs in Texas (NOW HIRING)

Driscoll

Service Coord - RN Valley

Mcallen, TX

Certain medically complex members with waiver services may require the RN to be responsible for the LTSS prior authorization activities. The Service Coordinator RN will collaborate with other members ...

IVX Health

Infusion Registered Nurse (RN)

Austin, TX · On-site

FT Registered Nurse (RN) | Austin Market Location(s): South Austin Infusion Center Full-Time | ... Support Operations and Training - Assist in inventory management, prior authorizations, and ...

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$6

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$67

How much do prior authorization rn jobs pay per hour?

As of May 29, 2026, the average hourly pay for prior authorization rn in Texas is $39.36, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $46.59 per hour, depending on experience, location, and employer.

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 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 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
Registered Nurse

Registered Nurse

US Department of Veterans Affairs

Houston, TX

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

U.S. Department Of Veterans Affairs rating

8.2

Company rating: 8.2 out of 10

Based on 623 frontline employees who took The Breakroom Quiz

33rd of 273 rated public sector bodies

Job description

Registered Nurse Opportunities

The Department of Veterans Affairs (VA) is seeking dedicated and compassionate Registered Nurses to provide comprehensive, patient-centered care to our nation's Veterans. As a VA RN, you will play a vital role in assessing, planning, implementing, and evaluating nursing care for a diverse patient population. You will work within an interdisciplinary healthcare team to promote health, prevent disease, and manage acute and chronic health conditions. Registered Nurses will be assigned to interested facilities throughout VHA and may be permanently or temporarily (not to exceed 1-year) appointed on intermittent, part-time, or full-time schedule in support of the VA facilities across the Nation.

Primary responsibilities include, but may not be limited to:

  • Provide direct and indirect patient care, ensuring adherence to established nursing standards, policies, and procedures.
  • Conduct comprehensive nursing assessments, identify patient needs, and develop individualized care plans in collaboration with the healthcare team, Veterans, and their families.
  • Administer medications and treatments as prescribed, monitor patient responses, and take appropriate action in accordance with VA guidelines.
  • Educate Veterans and their families on health conditions, medications, treatment plans, and self-care strategies to promote optimal health outcomes.
  • Maintain accurate, timely, and thorough electronic health records (EHR) documentation.
  • Utilize critical thinking skills to anticipate and respond to changes in patient conditions, initiating appropriate interventions and escalating concerns as necessary.
  • Participate in interdisciplinary team meetings to ensure coordinated and holistic patient care.
  • Adhere to all safety protocols and infection control practices.
  • Serve as a patient advocate, ensuring ethical considerations and Veterans' rights are respected.
  • Engage in continuous professional development and participate in quality improvement initiatives.

We are recruiting for the following specialties:

  • Critical Care (ICU, SICU, Recovery, OR, ER): Manages complex patient cases requiring advanced monitoring, life support, and rapid intervention.
  • Outpatient (Primary Care, CBOC, Mental Health): Focuses on health promotion, disease prevention, chronic disease management, and patient education in clinics.
  • Inpatient (Med/Surg, Mental Health, CLC): Provides direct care for hospitalized Veterans, managing a variety of medical, surgical, or psychiatric conditions.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary, regular salary increases, potential for performance awards

Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA

Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)

Licensure: One (1) full and unrestricted license from any US State or territory

Work Schedule: A variety of work schedules are available; Work schedule will be determined upon selection. NOTE: May be expected to work rotating weekends and holidays.

Telework: Not Available

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized

EDRP Authorized: Registered Nurses selected for the following specialties are eligible for the Education Debt Reduction Program (EDRP), a student loan reimbursement program: Inpatient Community Living Center, Inpatient Mental Health, Critical Care, and Outpatient Mental Health. You must meet specific eligibility requirements per VHA policy and submit your application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

Permanent Change of Station (PCS): Not Authorized

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