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

Affirmed Home Care

Pediatric RN

Enfield, CT · On-site

Pediatric Registered Nurse (RN) - Home Care Hartford County, CT | Per Diem | One-on-One Pediatric ... Authorized to work in the United States * Valid driver's license preferred * Physical examination ...

Posted today

HAN Staff

RN - ER

Hartford, CT · On-site

$121 - $123/hr

Authorized to work in the United States. * Graduate of an Accredited School of Nursing * 2 years of experience as a Registered Nurse (RN) - Emergency Room * American Heart Association BLS * An active ...

Maxim Health Systems

RN School

Longmeadow, MA · On-site

$50/hr

One year prior Registered Nurse (RN) experience preferred. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health ...

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Showing results 21-40

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

Prior Authorization Rn information

See Springfield, MA salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for prior authorization rn in Springfield, MA is $41.12, according to ZipRecruiter salary data. Most workers in this role earn between $30.62 and $48.65 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 Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $85,520 per year, or $41.1 per hour.

Registered Nurse (RN)

Aveanna Healthcare LLC

Holyoke, MA • On-site

Other

Medical, Dental, Vision, Life, PTO

Re-posted 13 days ago

Aveanna Healthcare rating

6.7

Company rating: 6.7 out of 10

Based on 202 frontline employees who took The Breakroom Quiz

63rd of 242 rated social care providers

Job description

Overview
Join a Company That Puts People First!
Registered Nurse - RN
We are one of the largest private duty nursing companies in the nation and growing! At Aveanna, we're proud to foster a workplace culture that celebrates diversity, encourages connection, and supports our team members every step of the way. Here's what sets us apart:
Award-Winning Culture
  • Indeed's Work Wellbeing Top 100 Company
  • Multi-year Comparably Award winner in the following categories: Best Company Culture, Best CEO, Best Company Work-Life Balance, Best Company Career Growth, Best Company for Diversity, Best Company for Women
Why Join Us?
  • Health, Dental, Vision and Company-Paid Life Insurance
  • Paid Time Off Available
  • Flexible scheduling- full-time, part-time, or PRN. Days, nights, and weekend shifts- we will work with your availability!
  • 24/7 Local support from operators and clinicians
  • Aveanna has a tablet in each patient's home allowing for electronic documentation
  • Career Pathing with opportunities for skill advancement and paid training
  • Weekly and/or Daily Pay
  • Employee Stock Purchase Plan with 15% discount
  • Employee Relief Fund
*Benefit eligibility can vary and is dependent upon employment status and employment location
We consider it both a privilege and an honor when we welcome a new patient into our Aveanna family. Our homecare is always delivered from a place of heartfelt compassion and empathy, and every one of our Registered Nurses (RN)s works together to make sure we achieve outstanding clinical outcomes. Aveanna isn't just a provider of compassionate homecare to children and adults. We are a national leader.
Qualifications
  • Must have and maintain an active, unencumbered license (RN) in the state in which the clinician will practice
    • Compact licenses must be transferred to your state of residence within 90 days
  • Current CPR certification (with hands-on component)- Aveanna can assist in obtaining this requirement after hire, if necessary.
  • TB skin test (current within last 12 months)
  • Six months prior hands-on nursing experience preferred but not required
  • Insert state-specific requirement here
  • Must have reliable transportation

Aveanna Healthcare is an Equal Opportunity Employer and encourages applicants from diverse backgrounds to apply.
CCPA Notice for Job Applicants, Contractors, and Employees Residing in California

What Aveanna Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Aveanna

Sourced by ZipRecruiter

Aveanna Healthcare is one of the nation's leading providers of pediatric and adult homecare in the nation. We lead with clinical quality and compassion, delivering care in over 200 locations in 23 states. While we have a national presence, we are very much a local provider in each community we serve. Our stated mission is to revolutionize the way pediatric healthcare is delivered, one patient at a time, and we hope you will help us fulfill that mission by joining the 30,000 nurses who already call Aveanna home. Apply today.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Atlanta, GA, US

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