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Prior Authorization Rn Jobs in Virginia (NOW HIRING)

Quadrant

Registered Nurse

Mclean, VA

$40/hr

Licensed as a Registered Nurse in the District of Columbia Cardiology knowledge Experience obtaining pre-authorizations Phone triage experience Ability to administer IV's Wound care Strong ...

HomeCentris Healthcare LLC

Registered Nurse

Fairfax, VA

$125/hr

Registered Nurse Case Manager Join the fastest growing homecare agency in the Mid-Atlantic. We are ... Provide nursing updates and obtain re-authorization for continued care. Write ISPs and quarterlies ...

HomeCentris Healthcare

Registered Nurse

Fairfax, VA · On-site

$100 - $125/hr

The Registered Nurse Case Manager assists in providing the overall management and supervision of ... Provide nursing updates and obtain re-authorization for continued care. Write ISPs and quarterlies ...

Neighborhood Health

Licensed Practical Nurse

Alexandria, VA

$27.50 - $37.25/hr

Assists with obtaining prior authorization for medications and urgent patient procedures. * Assists ... Current RN or LPN license in state of Virginia. * A minimum of one year of experience in healthcare ...

HomeCentris Healthcare

Registered Nurse

Leesburg, VA · On-site

$100 - $125/hr

The Registered Nurse Case Manager assists in providing the overall management and supervision of ... Provide nursing updates and obtain re-authorization for continued care. Write ISPs and quarterlies ...

Attend Home Care

Registered Nurse (RN)

Chantilly, VA · On-site

S. work authorization (valid, unexpired documents: government issued ID) * Reliable transportation Responsibilities: * Conducting Start of Care (SOC) visits to evaluate medical, physical, and ...

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Prior Authorization Rn information

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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.
Registered Nurse (RN)-Medical Services **Sign On Bonus Eligible**

Registered Nurse (RN)-Medical Services **Sign On Bonus Eligible**

Richmond Behavioral Health Authority

Richmond, VA

Full-time

Posted 10 days ago

Job description

RBH is now offering sign-on bonus opportunities for qualifying professionals!

The Richmond Behavioral Health Authority is seeking a full-time Registered Nurses (RN) for the expansion of Integrated Care. The RN's focus would be on health and wellness and would be responsible for providing general nursing and psychiatric services; these services include but are not limited to medical and psychiatric nursing assessments, vital signs, EKGs, venipuncture, intramuscular medication administration, urine drug screens, maintaining timely and thorough documentation of all services within regulatory and professional standards of practice. Work is performed under the administrative supervision of the Medical Services Practice Manager. Supervision is exercised over subordinate personnel as assigned.

Essential Functions

Provide assessment and screening of the risk factors for Metabolic Syndrome.

Obtains physician orders; collaborates with pharmacy and physician to assisting clients with medication refills as needed.

Provides linkage to community resources to promote wellness.

Administers medications both intramuscularly and orally according to nursing standards of practice. Provides medication and health wellness education to clients.

Completes medically related assessments including mental status exams, primary care screenings, monitoring medication side effects and medication adherence, administering treatment scales, i.e. the PHQ9 and taking vital signs on all clients across the life span per agency policy.

Draws blood and performs urine drug screens; labels specimens via computer printout; administers and interprets TB tests; processes gel top blood tubes via centrifuge; assists, monitors and tracks lab results. Reports abnormal lab results to the provider. Utilize universal precautions on all patients.

Implements and utilizes collaborative documentation.

Maintains thorough documentation of daily activities including nursing and treatment services.

Attends and participates on integrated treatment team; attends staff meetings and trainings as required. Collaborates with primary care and substance use services as clinically indicated.

Facilitates referrals to health professionals for behavioral health and medical needs.

Maintains productivity standards as set by division.

Coordinates schedules and ensures appropriate level of nursing services to clients to include monitoring, administration and documentation of injections, venipunctures and other nursing services; collaborates with treatment providers including primary care, developmental disabilities and substance use providers.

Coordinates schedule with providers and front desk staff.

Collaborates with all members of the client’s treatment team providing nursing plans of care to be integrated into the client’s treatment plan. Referrals to primary care as appropriate and in collaboration with primary service provider.

Provides crisis intervention services as needed

Orders medical supplies as needed and keeps workspace including labs clean and organized.

Attends staff meetings as scheduled.

Assists providers in the submission of prior authorizations as needed.

Performs other duties as assigned.

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