The Registered Nurse conducts pre-service, concurrent/ retrospective reviews. * They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to ...
The Registered Nurse conducts pre-service, concurrent/ retrospective reviews. * They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to ...
Registered Nurse (RN)
Austin, TX · On-site
Registered Nurse - RN - Nights (Full Time / Part Time Availabilities) We are one of the largest ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Austin, TX · On-site
Registered Nurse - RN - Nights (Full Time / Part Time Availabilities) We are one of the largest ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Round Rock, TX · On-site
Registered Nurse - RN - Part Time Weekend Days We are one of the largest private duty nursing ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Round Rock, TX · On-site
Registered Nurse - RN - Part Time Weekend Days We are one of the largest private duty nursing ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Red Rock, TX · On-site
Registered Nurse - RN - Full Time Days Our local office is looking for a team of compassionate ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Red Rock, TX · On-site
Registered Nurse - RN - Full Time Days Our local office is looking for a team of compassionate ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Cedar Park, TX · On-site
Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Cedar Park, TX · On-site
Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Austin, TX · On-site
Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Austin, TX · On-site
Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Round Rock, TX · On-site
Registered Nurse - RN - High Tech Nights - Full Time Availability We are one of the largest private ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Round Rock, TX · On-site
Registered Nurse - RN - High Tech Nights - Full Time Availability We are one of the largest private ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Manchaca, TX · On-site
Registered Nurse- RN - Full Time or Part Time Days Our local office is looking for a team of ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse (RN)
Manchaca, TX · On-site
Registered Nurse- RN - Full Time or Part Time Days Our local office is looking for a team of ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...
Registered Nurse ED
Austin, TX · On-site
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Registered Nurse ED
Austin, TX · On-site
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Infusion RN
Marble Falls, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Marble Falls, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Registered Nurse ED
$37.09/hr
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Registered Nurse ED
$37.09/hr
Registered Nurse obtained prior to hire date or job transfer date required. * One or more of the ... our authorized applicant tracking system. E-Verify statement Employer does not participate in E ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team! This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Austin, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Marble Falls, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Infusion RN
Marble Falls, TX · On-site
Overview Texas Oncology is looking for an Infusion Registered Nurse (RN) to join our team!This ... Assures pre-authorization and appropriate consent forms are obtained prior to administration of ...
Registered Nurse obtained prior to hire date or job transfer date required. Must have compact RN ... our authorized applicant tracking system. E-Verify statement Employer participates in the ...
Registered Nurse obtained prior to hire date or job transfer date required. Must have compact RN ... our authorized applicant tracking system. E-Verify statement Employer participates in the ...
Prior Authorization Rn information
See Austin, TX salary details
$7.38 - $13.21
0% of jobs
$13.21 - $19.04
0% of jobs
$19.04 - $24.86
4% of jobs
$24.86 - $30.69
18% of jobs
$31.45 is the 25th percentile. Wages below this are outliers.
$30.69 - $36.51
20% of jobs
The median wage is $38.91 / hr.
$36.51 - $42.34
18% of jobs
$47.58 is the 75th percentile. Wages above this are outliers.
$42.34 - $48.16
16% of jobs
$48.16 - $53.99
10% of jobs
$53.99 - $59.81
6% of jobs
$59.81 - $65.64
4% of jobs
$65.64 - $71.46
3% of jobs
$7
$41
$71
How much do prior authorization rn jobs pay per hour?
How to make $300,000 a year as a nurse?
How to make 150,000 as a nurse?
What is the difference between Prior Authorization Rn vs Medical Coder?
| Aspect | Prior Authorization Rn | Medical Coder |
|---|---|---|
| Credentials | RN license, possibly certifications in case management or utilization review | Certification in coding (CPC, CCS), no RN license required |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Medical offices, hospitals, insurance companies |
| Primary Responsibilities | Reviewing and obtaining prior authorizations for treatments and procedures | Translating 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.
What are the key skills and qualifications needed to thrive as a Prior Authorization RN, and why are they important?
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 some common challenges faced by Prior Authorization RNs, and how can they be addressed?
Can nurses do prior authorizations?
How to make an extra 2000 a month as a nurse?
What is a Prior Authorization RN?

Other
Posted 7 days ago
Job description
Established in 1995 and headquartered out of Southfield, MI, w3r Consulting is a national leader in technology consulting. We work tirelessly as a staffing firm to connect top talent to premier organizations across America while simultaneously helping corporations identify and maximize their business objectives and processes to ensure optimal success.
Operating out of 5 states currently, and expanding our consultant and client base daily, we realize building relationships are critical to the success of w3r. We value our relationships with our clients as much as we do with our employees and our business partners. These relationships are based on mutual interest, and create added value for all parties involved. Our low turnover, combined with our long-lasting relationships serve as a true testament of our strengths.
- See more at: http://www.w3r.com/about-us/#sthash.QEZKFTo8.dpuf
Experience:
 Private Duty, Home Health, Pediatrics, Children Special Healthcare Needs (CSHCN), Chronic Care Professional (CCP), CPO3.Â
- No direct patient care
- 8 hour shifts unless OT is needed and approved
- will have a shift between 7am and 7pm, so must be available for all shifts between that time.Â
- The Registered Nurse conducts pre-service, concurrent/ retrospective reviews.Â
- They will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.Â
- They will ensure medically appropriate, high quality, cost effective care through assessing the medical necessity of outpatient services, out of network services, and appropriateness of treatment setting within the scope of professional limitations by utilizing the applicable rules of the Texas Administrative Code (TAC), Texas Health and Human Services Commission (HHSC) approved medical policy, and industry standards, accurately interpreting benefits and managed care products.Â
- They may educate providers on programs or community resources that may benefit the member.Â
- The Registered Nurse will work with physicians in interpreting appropriateness of care. - Conducts pre-service, concurrent/ retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.Â
- Service requests may be from electronic transmission, inbound calls and facsimileÂ
- Makes outbound calls to the provider as required to gather additional information that may be needed - Utilizes client specific criteria sets, applicable client specific medical policy and client clinical guidelines for decision making to either approve or summarize and route to the clients nursing reviewer and/or clients medical staff for reviewÂ
- Conducts any utilization or medical management review activities which require the review of clinical information against client specific criteria as noted above, but excludes denial determinations -Â
- Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract - Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process -Â
- Collaborates with providers to assess members, needs for early identification of and proactive planning for discharge planning -Â
- Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required -Â
- Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accreditingÂ
Texas Licensed Registered Nurse
All your information will be kept confidential according to EEO guidelines.