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

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$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Sep 7, 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.

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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 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $85,404 per year, or $41.1 per hour.

7-on-7-off RN Hospice - Dayton, OH - Full Time

Registered Nurse

Moraine, OH • On-site

$80 - $100/hr

Other

Retirement

Posted 6 days ago

Key responsibilities

  • Conduct comprehensive and timely delivery of hospice care for patients and their families after regular business hours, including at night and on weekends.

  • Respond to crisis calls from patients and families afterhours with appropriate urgency and make initial nursing evaluations to determine eligibility for hospice services.

  • Perform afterhours visits such as admission visits, death visits, recertification visits, and routine visits based on patient needs.

Job description

Explore opportunities with Caretenders Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture ofCaring. Connecting. Growing together.

As the Afterhours Registered Nurse's your primary focus is to conduct comprehensive and timely delivery of hospice care for patients and their families after regular business hours, including at night and on the weekends.

This is a full-time salaried Hospice RN position providing home visits for hospice care.

Requirements
  • Active RN license in Ohio required
  • Prior hospice and/or home health experience required
  • Must be able to travel throughout the agency's 50-mile service area
On-Call Schedule
  • Weekday on-call: Monday through Friday, 4:30 PM to 8:00 AM
  • Weekend on-call: Friday 4:30 PM through Monday 8:00 AM
  • Schedule rotates one week on, one week off
  • Position includes scheduled visits and admissions as patient needs warrant
Primary Responsibilities:
  • Able to triage patient needs over the phone until a nurse can provide an in-person visit
  • Responds appropriately and with urgency to crisis calls from patients and families afterhours
  • Makes the initial nursing evaluation in determining eligibility for hospice services, as part of a patient visit, within forty-eight (48) hours of referral if assigned
  • Competent to perform afterhours visits including admission visits, death visits, recertification visits, and routine visits
  • Identifies the patient/family's physical, psychosocial, emotional, and environmental needs and reassess them as needed, no less than every fifteen (15) days
  • Documents problems, appropriate goals, interventions, and patient/family response to hospice care
  • Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • Current unrestricted RN licensure in the state of practice experience
  • Current driver's license, valid vehicle insurance, and access to a dependable vehicle, or public transportation
Preferred Qualifications:
  • Current CPR certification or ability to complete within 90 days of hire
  • 1+ years of clinical experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $74,560 to $111,840 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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