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Prior Authorization Rn Jobs in Springfield, MA (NOW HIRING)

Valley Health Systems

LPN /RN

Holyoke, MA

$34.33 - $53.81/hr

$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...

Valley Health Systems

LPN /RN

Holyoke, MA · On-site

$34.33 - $53.81/hr

$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...

Valley Health Systems

LPN /RN

Holyoke, MA · On-site

$34.33 - $53.81/hr

$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN ... Manage Prior Authorization, Med Refills, Triage Call and voicemails * Conduct ambulatory nurse ...

Valley Health Systems

Registered Nurse

Holyoke, MA · On-site

$34.33 - $53.81/hr

... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA

$34.33 - $53.81/hr

... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA · On-site

$34.33 - $53.81/hr

... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA

$34.33 - $53.81/hr

... prior authorizations, prescription refills, and adherence to clinical protocols Qualifications ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA · On-site

$34.33 - $53.81/hr

... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA · On-site

$34.33 - $53.81/hr

... prior authorizations, prescription refills, and adherence to clinical protocols Qualifications ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Valley Health Systems

Registered Nurse

Holyoke, MA

$34.33 - $53.81/hr

... * Assist in prior authorizations, prescription refills, and adherence to clinical protocols ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Home Care Evolution

Registered Nurse

Springfield, MA · On-site

$32 - $100/hr

Prior RN experience in homecare or clinical settings * Strong interpersonal and patient care skills * Current driver's license * CPR/First Aid certified Ready to make a difference as a Registered ...

Aveanna Healthcare

Registered Nurse (RN)

Holland, MA · On-site

Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Insert state-specific ...

Aveanna Healthcare

Registered Nurse (RN)

Westfield, MA · On-site

Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Insert state-specific ...

Aveanna Healthcare

Registered Nurse (Rn)

Torrington, CT · On-site

Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... Six months prior hands-on nursing experience preferred but not required * Insert state-specific ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Springfield, MA

Prior Authorization Rn information

See Springfield, MA salary details

$7

$42

$71

How much do prior authorization rn jobs pay per hour?

As of Aug 1, 2026, the average hourly pay for prior authorization rn in Springfield, MA is $42.10, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $49.81 per hour, depending on experience, location, and employer.

What do prior authorization nurses do?

Prior authorization nurses review medical documentation and communicate with healthcare providers and insurance companies to obtain approval for specific treatments, medications, or procedures. They ensure that requests meet insurance criteria, often using electronic health records and authorization systems, to facilitate timely patient care.

How to make 150,000 as a nurse?

A Prior Authorization RN can earn $150,000 by gaining extensive experience, obtaining relevant certifications, and working in high-paying settings such as specialty clinics or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting opportunities can also increase earning potential.

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.

How to make $300,000 as a nurse?

A Prior Authorization RN can increase earnings by gaining specialized certifications, working in high-paying healthcare settings, or taking on overtime and extra shifts. Developing expertise in insurance processes and healthcare regulations can also lead to higher-paying roles or consulting opportunities.

How to make an extra 2000 a month as a nurse?

A Prior Authorization RN can increase income by taking on overtime shifts, working in high-demand specialties, or obtaining certifications to qualify for higher-paying roles. Additionally, freelance consulting or remote review work can provide supplementary income outside regular hours.

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 popular job titles related to Prior Authorization Rn jobs in Springfield, MA? For Prior Authorization Rn jobs in Springfield, MA, the most frequently searched job titles are:
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Springfield, MA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 60% In-person, 10% Hybrid, and 30% Remote job distribution, with an average salary of $87,560 per year, or $42.1 per hour.

LPN /RN

Valley Health Systems

Holyoke, MA

$34.33 - $53.81/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 12 days ago

Job description

$5,000 SIGN-ON BONUS FOR FULL-TIME RN & LPN's

WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN or LPN

Note: The compensation range noted above represents the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range.

Valley Health Systems, Inc., the parent company of Holyoke Medical Center, provides a broad range of physician services in offices conveniently located throughout Western Massachusetts. 

Holyoke Medical Center is an independent community hospital that has served the healthcare needs of the Pioneer Valley for over 125 years. We continue to grow and address the needs of our community through quality and patient-centered care. 

Our Neurology & Sleep Outpatient Physician Practice is seeking a registered nurse (RN) or licensed practical nurse (LPN) to provide nursing care and assist in the coordination of that care, including, but not limited to:

  • Follow up and referrals, as necessary. 
  • Facilitate optimal clinical workflow
  • Assist each provider during patient visit, including procedures.
  • Prepares supplies, equipment and instruments for patient procedures
  • Removes sutures, staples and performs dressing changes
  • Infusion scheduling
  • Participates in patient education to include instruction on the required pre-operative protocol for care at home.
  • Manage Prior Authorization, Med Refills, Triage Call and voicemails 
  • Conduct ambulatory nurse visits
  • Complete FMLA/Disability Paperwork

Qualifications:

Education: Graduate of an accredited program for Registered Nurses or accredited LPN Program

License/Certification: Current license as a Registered Nurse within the Commonwealth of Massachusetts or Current license as a Licensed Practical Nurse within the Commonwealth of Massachusetts; current CPR

Experience: Two years of experience in an outpatient physician's office, preferably in the specialty.

Our competitive salary package is adjusted to align with a candidate's relevant experience and skills. We also offer:

  • Low cost health insurance with no deductibles when using HMC services
  • Dental and vision insurance
  • Free disability and life insurance
  • 403(b) plan
  • Up to $8000 in degree/tuition reimbursement
  • In-House Pharmacy
  • Relaxation Room and Fitness Center
  • Other voluntary benefits, such as LegalShield, Pet Insurance
  • Free onsite parking

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