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

Maxim Health Systems

RN School

Springfield, 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 ...

IntelliResume

RN Emergency Department

Hartford, CT · On-site

$85 - $105/hr

Current Connecticut RN license required prior to start date. * BLS certification by the American Heart Association required prior to date of hire. Benefits * Tuition Assistance up to $5,250.00 per ...

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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) - Medicine StepDown

Hartford HealthCare at Home

Hartford, CT • On-site

Part-time

Re-posted 11 days ago

Job description

Work where every moment matters.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford Hospital is one of the largest and most respected teaching hospitals as well as a Level I trauma center. Hartford Hospital is on the cutting edge of technology & medical care and is home to the Center for Education, Simulation and Innovation (CESI), one of the most-advanced medical simulation training centers in the world. Housing the Northeast's largest robotic surgery center, committed to becoming the best in the country for patient safety and is pursuing that goal by taking innovative action and creating a culture of safety at every level within the organization.
Job Summary
Our Nurses work in collaborative environments with strong interdisciplinary teams, focused on a patient centered care model in a richly diverse work space. Under the direction and general supervision of the Nurse Manager, the registered nurse utilizes evidence based practices in accordance with the State Nurse Practice Act, policies and procedures of the hospital and as directed by the medical staff. The registered nurse who through knowledge and ability uses the nursing process to develop a plan of care which includes standards of practice to meet the physical, emotional spiritual, cultural and educational needs of the patient and family.
Bliss 11 Step Down is a 18-bed unit that provides care to patients with a wide range of complex, highly acute medical issues. These issues include but are not limited to; respiratory failure, gastrointestinal bleeding, liver injury/failure, kidney injury/failure, sepsis, drug and alcohol withdrawal and a specialty in the care of the pulmonary hypertension population. Under the supervision of a Critical Care Pulmonologist, the unit is staffed 24 hours-a-day with a team of Physician Assistants and Advanced Practice Registered Nurses.
In the Medicine Step Down, our goal is to develop our staff into well-rounded, highly skilled medical professionals. The unit will push you to your limits as you will be working in a fast-paced environment where your critical thinking, vast medical knowledge, clear communication, and your extensive skillset will be challenged and grown.
Qualifications:
Qualifications
  • Current Connecticut RN License prior to Orientation.
  • Graduate of an accredited nursing school (BSN required).
  • BLS certification by the American Heart Association required prior to Orientation.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
As an Equal Opportunity Employer/Affirmative Action employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
Hartford HealthCare at Home logo

About Hartford HealthCare at Home

Sourced by ZipRecruiter

Hartford HealthCare at Home, based in Wethersfield, Connecticut, US, is a premier provider in the healthcare industry, specifically in home-based care services. Their official website can be accessed at hartfordhealthcareathome.org. They offer a wide range of services including nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aid. The company was established with the mission to enhance the capability of people to achieve optimal health and wellbeing through its home care services. They maintain a patient-centric approach and belief in making a real difference in people's lives. As an integral part of Hartford HealthCare, they share the vision to be “most trusted for personalized coordinated care”.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Wethersfield, CT, US

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