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Prior Authorization Rn Jobs in Virginia (NOW HIRING)

WomanCare Centers

Prior Authorization Nurse

Norfolk, VA · On-site

$25 - $31/hr

WomanCare Centers Prior Authorization Nurse We are a busy, patient-centered OB/GYN outpatient practice dedicated to providing compassionate, comprehensive care to women at every stage of life. Our ...

MFA

Prior-Authorization Technician- Pharmacy

Arlington, VA · On-site

$23.46 - $30.50/hr

Position Summary The Prior Authorization Technician will process prior authorizations and locate ... Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered Physical ...

MFA Co

Prior-Authorization Technician- Pharmacy

Arlington, VA · On-site

$20.25 - $24.50/hr

Position Summary The Prior Authorization Technician will process prior authorizations and locate ... Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered Physical ...

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$45 - $50/hr

Intake RN-PRN | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: About ... Facilitates intake, admission, and prior authorization process for incoming patients. * Performs ...

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$45 - $50/hr

Intake RN-PRN | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: About ... Facilitates intake, admission, and prior authorization process for incoming patients. * Performs ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Virginia

Prior Authorization Rn information

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$7

$41

$71

How much do prior authorization rn jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for prior authorization rn in Virginia is $41.88, according to ZipRecruiter salary data. Most workers in this role earn between $31.20 and $49.57 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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What are the most commonly searched types of Prior Authorization Rn jobs in Virginia?

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For Prior Authorization Rn jobs in Virginia, the most frequently searched job titles are:

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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 24% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $87,114 per year, or $41.9 per hour.

Prior Authorization Nurse

WomanCare Center, PLC

Norfolk, VA • On-site

Other

PTO

Posted 6 days ago

Job description

WomanCare Centers Prior Authorization Nurse

We are a busy, patient-centered OB/GYN outpatient practice dedicated to providing compassionate, comprehensive care to women at every stage of life. Our team values communication, collaboration, and continuity of care—both in and out of the office. We're seeking an experienced Medication Prior Authorization Nurse to join our dynamic team in an in-person, non-remote position. The primary focus of this role is the timely and accurate management of medication prior authorizations, working closely with providers, pharmacies, insurance companies, and patients to facilitate access to prescribed medications.

Responsibilities:
  • Manage medication prior authorizations as the primary responsibility of the position, including initiating, completing, submitting, and tracking prior authorization requests.
  • Review medication orders and insurance requirements to determine appropriate prior authorization processes and required documentation.
  • Gather and submit supporting clinical documentation, including diagnoses, treatment history, laboratory results, and other information required for authorization.
  • Monitor pending prior authorizations and proactively follow up to ensure timely resolution and minimize delays in patient treatment.
  • Assist with appeals, reconsiderations, peer-to-peer requests, and alternative medication options when prior authorization requests are denied, as directed by the provider.
  • Maintain accurate and timely documentation of all prior authorization activities in the electronic health record (EHR).
  • Process medication refill requests as appropriate, ensuring clinical appropriateness and adherence to established protocols.
  • Stay current with payer requirements, medication authorization processes, and changes that may affect patient access to medications.
  • Other duties as assigned.
Qualifications Desired
  • Minimum of 2 years of nursing experience in Prior Authorizations.
  • Strong clinical assessment, critical thinking, and problem-solving skills.
  • Excellent communication, organization, documentation, and time-management skills.
  • Strong attention to detail and ability to manage multiple prior authorizations and follow-up tasks simultaneously.
  • Ability to work independently while collaborating effectively with providers, pharmacies, insurance companies, and members of the care team.
  • Compassionate, patient-centered approach to care.
  • Ability to work in person; this position is not eligible for remote work.
  • Familiarity with medication formularies.
  • Knowledge of common OB/GYN conditions, including prenatal care, contraception, menstrual issues, menopause, infections, and pregnancy complications.
Why Join Our Team?
  • Paid time off that increases with tenure.
  • Major federally recognized holidays off with pay.
  • Competitive benefits package with optional supplemental benefits.
  • Leadership dedicated to cultivating and maintaining a positive environment that encourages professional growth.
  • Opportunities to take on healthy challenges and develop your clinical and administrative skills.
  • A collaborative team environment with coworkers who encourage and support one another in achieving success.

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