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Prior Authorization Rn Jobs in Katy, TX (NOW HIRING)

IVX Health

Infusion Registered Nurse (RN)

Houston, TX · On-site

FT Registered Nurse (RN) | Houston Market Location(s): Clear Lake Infusion Center + Washington ... Support Operations and Training - Assist in inventory management, prior authorizations, and ...

Discovery Behavioral Health

RN

Houston, TX · On-site

$39 - $50/hr

The Registered Nurse (RN) is a vital member of a dynamic, multidisciplinary team, delivering ... securing prior authorizations for necessary treatments and tests. Documentation & Compliance

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Prior Authorization Rn information

See Katy, TX salary details

$6

$38

$66

How much do prior authorization rn jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for prior authorization rn in Katy, TX is $38.76, according to ZipRecruiter salary data. Most workers in this role earn between $28.89 and $45.87 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.
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Katy, TX as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $80,617 per year, or $38.8 per hour.

Pharmacy Technician Prior Authorization

Shields Health Solutions

Houston, TX • On-site

$16.75 - $20.25/hr

Full-time

Posted 5 days ago

Shields Health Solutions rating

8.3

Company rating: 8.3 out of 10

Based on 39 frontline employees who took The Breakroom Quiz

12th of 112 rated pharmacies

Job description

Join our Shields team today!

Shields Health Solutions is redefining patient care through specialty pharmacy. We're hiring a Prior Authorization Pharmacy Technician - Patient Support Advocate to support the growth of the specialty pharmacy program. This role supports patient access to medications by coordinating prior authorizations, securing financial assistance, and resolving insurance barriers. It includes patient communication, claim adjudication, and promoting medication adherence through pharmacy system support.

Active Texas Pharmacy Technician License AND National Pharmacy Technician Certification REQUIRED

Remote, Monday - Friday, 9:00AM - 6:00PM CST

What You'll Do:

  • Work with insurance companies to obtain medication approvals.
  • Use pharmacy systems to enter data, run test claims, and manage follow-up actions.
  • Document patient needs, authorization status, and assistance efforts across systems and EMRs.
  • Communicate with prescribers to ensure accurate and appropriate prescriptions.
  • Maintain detailed records of all patient interactions.
  • Assist patients with insurance claims and medication adherence over the phone.
  • Partner with pharmacists and liaisons to support coordinated patient care.
  • Research information to support decisions and operational improvements.
  • Manage and update data in relevant databases.
  • Identify issues, recommend solutions, and participate in process improvement initiatives.
  • Maintain confidentiality and ongoing professional development.
  • Perform additional duties as needed; minimal travel may be required.

What You'll Get:

  • Medical, dental, and vision insurance starting day one
  • 401(k) with match, 4 weeks PTO, 10 paid holidays
  • Paid parental leave, short-term disability, and professional development
  • Access to employee resource groups and wellness programs

What You Need:

  • State-registered (Texas) Pharmacy Technician; CPhT required.
  • 2+ years of experience as a pharmacy technician; High School Diploma or GED
  • Strong communication, organization, and tech skills
  • Empathy, integrity, and a team-first mindset

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.

By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Shields Health Solutions is committed to providing an inclusive hiring experience; if you need assistance or accommodation during the application or interview process, please email talentacquisition@shieldsrx.com.

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