ZipRecruiter

Log In

1

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

next page

Showing results 1-20

All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Dayton, OH

Prior Authorization Rn information

See Dayton, OH salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for prior authorization rn in Dayton, OH is $41.06, according to ZipRecruiter salary data. Most workers in this role earn between $30.62 and $48.61 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.

More about Prior Authorization Rn jobs

What are the most commonly searched types of Prior Authorization Rn jobs in Dayton, OH?

The most popular types of Prior Authorization Rn jobs in Dayton, OH are:

What are popular job titles related to Prior Authorization Rn jobs in Dayton, OH?

For Prior Authorization Rn jobs in Dayton, OH, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Rn jobs in Dayton, OH look for?

The top searched job categories for Prior Authorization Rn jobs in Dayton, OH are:

What cities near Dayton, OH are hiring for Prior Authorization Rn jobs?

Cities near Dayton, OH with the most Prior Authorization Rn job openings:

Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Dayton, OH as of August 2026, with employment types broken down into 3% As Needed, 79% Full Time, 9% Part Time, 3% Temporary, and 6% Contract. Highlights an 100% In-person job distribution, with an average salary of $77,446 per year, or $37.2 per hour.

RN Field Coordinator

Longevity Health Plan

Miamisburg, OH • On-site

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Description
Join us in transforming healthcare.
Longevity Health's Statement of Purpose is to improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs.
Job Summary:
This role blends hands-on patient care with administrative coordination in long-term care settings. The RN Field Coordinator is instrumental in supporting Longevity Health's Institutional Special Needs Plan (I-SNP), ensuring smooth transitions of care, and educating facility staff on our clinical model. The RN Field Coordinator will travel to various Nursing Homes upon request and assignment by the Market Director of Clinical Services (MDCS).
Requirements
Key Tasks and Responsibilities:
  • Conduct in-person visits at multiple nursing homes to assist Advanced Practice Providers (Nurse Practitioners) with clinical and administrative tasks.
  • Use facility EMRs to prescreen new enrollees and identify continuity of care needs, including access to external specialists.
  • Collaborate with clinical and operations teams to oversee member appointments and ensure timely communication with providers and facility staff.
  • Support transitions of care, assist with prior authorization requests, and help members access services outside the nursing facility.
  • Communicate with patients, families, and physicians as delegated by nurse practitioners.
  • Lead orientation sessions for new and existing nursing homes to educate staff on Longevity Health Plan model of care.
  • Help initiate telehealth services in newly onboarded facilities, including staff education and follow-up.
  • Maintain proficiency in the Longevity Health Plan electronic medical record system and assist with data entry when needed.
  • Participate in clinical meetings and contribute to hospitalization review sessions.
  • Perform additional responsibilities as assigned by the Market Director of Clinical Services (MDCS), based on caseload and team needs.

Credentials & Coverage:
  • Licensed registered professional nurse in good standing.
  • Valid state drivers' license with a good driving record and proof of automobile insurance required.
  • Auto insurance coverage as required by your state of residence. New employees will be responsible for providing proof of coverage prior to hire and on an ongoing basis.

Education and Training:
  • Associate degree in nursing required, bachelor's degree in nursing or other healthcare related discipline but must be a licensed professional registered nurse.

Knowledge and Experience:
  • Nursing home background or health plan case management experience preferred.
  • Minimum 2 years' experience as a Registered Nurse.
  • Excellent verbal and written communication skills.
  • Excellent computer skills, EMR/clinical Platform/MS Office Products.
  • Knowledge of the challenges and opportunities to serve the long-term nursing home population.
  • Able to travel.
  • Required to have managed care coordination background/experience.

Apply