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Prior Authorization Rn Jobs in Louisville, KY (NOW HIRING)

BrightSpring

Prior Authorization Specialist

Louisville, KY · On-site

$16.50 - $22/hr

The Prior Authorization Coordinator is responsible for striving to complete either approval for ... as skilled nursing facilities, senior living communities, and hospitals. We also cater to ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

The Prior Authorization Coordinator is responsible for striving to complete either approval for ... as skilled nursing facilities, senior living communities, and hospitals. We also cater to ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

The Prior Authorization Coordinator is responsible for striving to complete either approval for ... as skilled nursing facilities, senior living communities, and hospitals. We also cater to ...

Crown Staffing LLC

Psych Clinical RN

Louisville, KY · On-site

$40 - $44/hr

Experience with prior authorizations, medical documentation, and electronic medical records ... Registered Nurse for a private outpatient psychiatry practice in Louisville, KY. This unique ...

Oak Street Health

Registered Nurse

Eastwood, KY · On-site

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

New

Oak Street Health

Registered Nurse

Eastwood, KY · On-site

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

CVS Health

Registered Nurse

Louisville, KY · On-site

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

CVS Health

Registered Nurse

Louisville, KY

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

Oak Street Health

Registered Nurse

Eastwood, KY · On-site

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

Oak Street Health

Registered Nurse

Eastwood, KY · On-site

Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

New

Oak St. Health

Registered Nurse

Louisville, KY · On-site

Registered Nurse We're building a world of health around every individual -- shaping a more ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Louisville, KY

Prior Authorization Rn information

See Louisville, KY salary details

$7

$40

$69

How much do prior authorization rn jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for prior authorization rn in Louisville, KY is $40.57, according to ZipRecruiter salary data. Most workers in this role earn between $30.24 and $48.03 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 Louisville, KY as of August 2026, with employment types broken down into 2% As Needed, 79% Full Time, 15% Part Time, 2% Temporary, and 2% Contract. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $84,395 per year, or $40.6 per hour.

Prior Authorization Specialist

BrightSpring Health Services

Louisville, KY • On-site

$16.50 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

BrightSpring Health Services rating

4.9

Company rating: 4.9 out of 10

Based on 64 frontline employees who took The Breakroom Quiz

220th of 242 rated social care providers

Job description

PharMerica


Join our PharMerica team!  PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients.  We offer a non-retail pharmacy environment.  Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression! 

Schedule: Mon-Fri(8:30am to 5pm)

This is not a remote opportunity. Applicants must reside in, or commutable distance, to Louisville, KY

We offer:

DailyPay 

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

*Position will be posted for a minimum of 7 business days


  • The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question

Essential Job Responsibilities:

  • Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
  • Follows up on all claims requiring prior authorization within four to five business days
  • Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
  • Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
  • Assists Billing Department with resolving unbilled claims at each month end close
  • Advocates for clients as needed
  • Support for Pharmacy Operations
  • Adjudicates and resolution of claim rejections as needed
  • Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
  • Other responsibilities as assigned

  • High School Diploma/General Education Diploma required
  • Kentucky Pharmacy Technician License preferred
  • Excellent customer service and communication skills, both written and verbal
  • Ability to prioritize and meet pre-determined deadlines
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
  • Experience in healthcare billing environment (pharmacy preferred)
  • Familiarization with on-line claims processing and Medicaid and Medicare billing practices
  •  Proficient with Microsoft Word & Excel required

PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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