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Prior Authorization Rn Jobs in Columbus, OH (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership ... Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership ... Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be ...

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Prior Authorization Rn information

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How much do prior authorization rn jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for prior authorization rn in Columbus, OH is $40.80, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $48.32 per hour, depending on experience, location, and employer.

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.

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 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?

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.
More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in Columbus, OH? The most popular types of Prior Authorization Rn jobs in Columbus, OH are:
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What cities near Columbus, OH are hiring for Prior Authorization Rn jobs? Cities near Columbus, OH with the most Prior Authorization Rn job openings:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Columbus, OH as of July 2026, with employment types broken down into 4% As Needed, 70% Full Time, 11% Part Time, 13% Contract, and 2% Nights. Highlights an 96% In-person, and 4% Remote job distribution, with an average salary of $84,871 per year, or $40.8 per hour.

Prior Authorization Specialist

Equitas Health

Columbus, OH • On-site

$18.13 - $21.78/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 22 days ago

Equitas Health rating

5.4

Company rating: 5.4 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Prior Authorization Specialist

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation's largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

Hourly rate: $18.13-$21.78

Benefits: PTO, vision, dental, health, 401k, sick time

Position Summary

The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work with internal and external pharmacies, CoverMyMeds, the EHR, and all Equitas Health health center providers to facilitate prior authorization completion. This individual must be able to work in conjunction with the pharmacy department and health center staff to facilitate the prior authorization process.

Essential Job Functions

The Prior Authorization Specialist is responsible for handling all prior authorizations, appeals, and third party medication disputes for providers at Equitas Health. The Prior Authorization Specialist will be required to communicate with prescribers, pend medication changes, and maintain exceptional documentation in the patient health record. The staff member will also be in constant communication with internal pharmacies, external pharmacies, and patients waiting on prior authorizations.

Major Areas of Responsibilities
  • Complete prior authorizations submission within established time frame.
  • Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party representatives.
  • Ensure proper documentation is maintained in the EHR.
  • Work with clinical pharmacist team to provide potential therapeutic substitutions to prescribers
  • Communicate with the clinical team on the status of prior authorizations or changes that must be made for therapy to continue for the patient.
  • Maintain constant communication with the internal and external pharmacy teams for medication processing.
  • Inform patients when prior authorizations are approved.
  • Provide data on prior authorizations as needed to Senior Leadership.
  • Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership.
  • Comply with the Equitas Health Care Corporate Compliance Standards of Conduct and related policies and procedures.
  • Demonstrate unconditional positive regard to clients and conduct all aspects of job responsibilities.
  • Continuously grow and develop cultural competency, exhibiting an understanding, awareness, and respect for diversity.
  • Contribute to a positive work environment by demonstrating unconditional positive regard to all Equitas Health employees, interns, etc. with an understanding, awareness, and respect for diversity.
Education/Licensure
  • Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be registered with State of Ohio Board of Pharmacy).
Knowledge, Skills, Abilities and other Qualifications
  • Experience working in medical records preferred.
  • Must be able to accurately and effectively meet established deadlines
  • Experience with prior authorizations preferred.
  • Strong attention to detail.
  • Ability to be flexible in working hours.
  • Must ensure detailed and thorough documentation.
  • Exemplary written and verbal communication skills.
  • Knowledge of healthcare terminology.
  • Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, chemical dependency and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender community.
  • Proficiency in all Microsoft Office applications, computers, email, web-based systems and electronic health records.
  • Reliable transportation, driver's license and proof of auto insurance required.

Background and reference checks will be conducted. In accordance with Equitas Health's Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

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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