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Prior Authorization Rn Jobs in Virginia (NOW HIRING)

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 ...

Summit BHC

Intake RN- Days

Williamsburg, VA · On-site

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

Summit BHC

Intake RN- Days

Williamsburg, VA

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

IntelyCare

Registered Nurse

Gate City, VA

$60.52K - $129.62K/yr

Registered Nurse We're building a world of health around every individual -- shaping a more ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...

Oak Street Health

Registered Nurse

Richmond, VA · On-site

$60.52K - $129.62K/yr

Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...

Oak Street Health

Registered Nurse

Richmond, VA · On-site

$60.52K - $129.62K/yr

Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...

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How much do prior authorization rn jobs pay per hour?

As of May 30, 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 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.

More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in Virginia? The most popular types of Prior Authorization Rn jobs in Virginia are:
What are popular job titles related to Prior Authorization Rn jobs in Virginia? For Prior Authorization Rn jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Virginia look for? The top searched job categories for Prior Authorization Rn jobs in Virginia are:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Virginia as of May 2026, with employment types broken down into 2% As Needed, 53% Full Time, 40% Part Time, and 5% Contract. Highlights an 95% Physical, 2% Hybrid, and 3% Remote job distribution, with an average salary of $87,114 per year, or $41.9 per hour.
Prior-Authorization Technician- Pharmacy

Prior-Authorization Technician- Pharmacy

MFA

Arlington, VA • On-site

$23.46 - $30.50/hr

Full-time

Posted 23 days ago

Job description

Position Summary
The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers.
Essential Duties and Responsibilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Under the direct supervision of a licensed Pharmacist:
  • Initiate prior authorizations for medications and work with providers on completion
  • Confirm patient demographics are accurate and insurance information is correct
  • Communicate with the clinical team and patients about prior authorization status and provide updates accordingly
  • Identify patient foundation assistance and manufacturer copay assistance programs
  • Follow up with the pharmacy to ensure the medication is in process after approval received
  • Process prior authorization renewals
  • Work with the provider to resolve prior authorization denials, peer-to-peer reviews, and denials
  • At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
  • Refer issues that require professional judgment to a pharmacist for follow-up
  • Other duties assigned

Minimum Qualifications
Education
  • High school diploma or an equivalent combination of education, training, and experience

Licenses/Certifications
  • A valid and active DC, MD, or VA pharmacy license is required.

Experience
  • A minimum of 2 years of Pharmacy Technician experience in retail, specialty, or mail-order pharmacy and a pharmacy license ( Must have a DC MD or VA active pharmacy license
    • A minimum of 2 years in an alternative healthcare role (i.e. Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered

Physical Requirements
  • Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
  • Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
  • Regularly exposed to healthcare settings that may require personal protective equipment
  • Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.

About GW MFA
MFA physicians provide comprehensive patient care, offering one practice for the whole person with 52 medical and surgical specialties. As members of the GW School of Medicine and Health Sciences faculty, MFA providers are teachers and mentors for medical students, residents, fellows, and researchers preserving the rich tradition of academics, research, and healing. In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH) which is separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals.
The GW MFA's leading healthcare presence in the DC metro region is complemented by a network of community-based practices in DC, Maryland, and Virginia. Given its geographic location in central NW Washington, DC, and proximity to more than 175 resident embassies, the MFA continues to evolve its international clinical outreach.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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