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Prior Authorization Rn Jobs in Washington (NOW HIRING)

The Ark of DC

Home Health Field RN

Washington, DC · On-site

Prepare monthly visit schedule prior to start of month. Gives copy to director of clinical services ... Accepting and reviewing the beneficiary's PCA Service Authorization and initial assessment or ...

Trusted Doctors, LLC

Registered Nurse

Fairfax, VA · On-site

Experienced Full Time Registered Nurse We are looking for an Experienced Full Time Registered Nurse ... prior written authorization from the parent/guardian (or patient is he/she has reached majority)

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Prior Authorization Rn information

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$8

$47

$81

How much do prior authorization rn jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for prior authorization rn in Washington is $47.85, according to ZipRecruiter salary data. Most workers in this role earn between $35.67 and $56.63 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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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Washington as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $99,519 per year, or $47.8 per hour.

Outpatient Registered Nurse (RN) -Orthopedics

Fairfax, VA • On-site

Inova Health System
Health Care and Social Assistance • 10K+ employees
Learn more about Inova Health Systemexternal

Other

Medical, Dental, Vision

Posted 28 days ago

Inova Health System rating

7.5

Company rating: 7.5 out of 10

Based on 261 frontline employees who took The Breakroom Quiz

Job description

Outpatient Registered Nurse (RN) - Orthopedics

Job Description

Inova Health - Orthopedics is looking for a dedicated Outpatient Registered Nurse (RN) to join the team. This role will be full time day shift from Monday – Friday, 7:30am - 4:00pm OR 8:00am – 4:30pm.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits:

Committed to Team Member Health:offering medical, dental and vision coverage, and a robust team member wellness program.

Retirement:Inova matches the first 5% of eligible contributions – starting on your first day.

Tuition and Student Loan Assistance:offeringup to $5,250 per year in education assistance and up to $10,000 for student loans.

Mental Health Support:offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.

Outpatient Registered Nurse (RN) Job Responsibilities:

Performs essential duties necessary to clinic or non-acute operations to include:

Prior Authorizations

Triage Call Center

Provide provider support.

Assist with other administrative tasks as needed.

Provides safe/therapeutic care in a holistic and systematic way in a physician practice or other outpatient setting. Incorporates differences into the provision of care while integrating knowledge, skills and experiences to meet the needs of patients and families to include patient and family education. Achieves desired patient outcomes by using an integrated approach.

Incorporates data and information to improve care and enhances outcomes while ensuring improvements in practice settings. Provides direction and guidance to others regarding practice while serving as a resource, preceptor and mentor.

Ensures efficiency in the delivery of care. Determines immediate priorities and offers solutions for problems. Works with the team to achieve maximum productivity.

Makes independent clinical decisions based on knowledge drawn from education and experience.

Minimum Qualifications:

Education: Bachelor's Degree Nursing or Associate's Degree. If RN has an Associate's Degree, within 2 years of date of hire

Licensure: RN licensed, or eligible to practice in the Commonwealth of Virginia as a Registered Nurse.

Experience:0 years of experience

Certification:BLS from the American Heart Association.

Preferred Qualifications:

6 months experience as a Registered Nurse

Experience with high volume triage call center for orthopedics, sting nursing skills.

About Us

We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world‑class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in‑class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better — to shape a more compassionate future for healthcare.

Inova Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy‑related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.

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