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

Associated Home Care

Registered Nurse (RN)

Springfield, MA · On-site

$39 - $41/hr

HIPPA and Safety. 4. Review Personal Care Plans from Aging service Access Points, (ASAP), orienting aides in following the care plan as authorized by the ASAP RN. 5. Documents services rendered and ...

HAN Staff

RN - ER

Hartford, CT

$2.3K/wk

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 ...

HAN Staff

RN - M/S Tele

Hartford, CT

$2.1K/wk

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

Veracity

RN - Emergency Room

Hartford, CT

RN - Emergency Room Location: Hartford, CT 06105 Position Type: 1 Contractor - Onsite Department ... Work Authorization (US Citizen / GC / H1B / Other - Specify): Expected Hourly Rate: W2 or C2C? (If ...

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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

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Jun 20, 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.

How to make $300,000 a year as a nurse?

A Prior Authorization RN can earn $300,000 annually by gaining extensive experience, obtaining advanced certifications, and working in high-paying settings such as specialty clinics or insurance companies. Increasing workload, taking on leadership roles, or working overtime can also boost income, but reaching this level typically requires a combination of expertise, efficiency, and strategic employment choices.

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.

Can nurses do prior authorizations?

Prior authorization nurses, often called utilization review nurses or case managers, are qualified to handle prior authorization requests. They review medical documentation, communicate with providers and insurance companies, and ensure compliance with payer requirements, often using electronic health record systems. Certification in case management or utilization review can enhance their ability to perform these tasks effectively.

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

A Prior Authorization RN can increase income by taking on additional shifts, working overtime, or offering consulting services to healthcare providers. Developing specialized knowledge in insurance authorization processes and obtaining relevant certifications can also lead to higher-paying opportunities or freelance work 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.
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Springfield, MA as of June 2026, with employment types broken down into 57% Full Time, 41% Part Time, 1% Temporary, and 1% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $85,520 per year, or $41.1 per hour.
Registered Nurse (RN)

Registered Nurse (RN)

Associated Home Care

Springfield, MA

$39 - $41/hr

Other

Posted 3 days ago

Job description

" This position offers 20-24 hours per week with a flexible and accommodating schedule based on consumer needs. Hours are primarily during weekdays, with occasional weekend availability as needed."
About Associated Home Care
Fueled by a real understanding of today's challenges, Associated is committed to a fundamental re-imagining of what it means to age. With over 20 years of operating experience, we have built a replicable service prototype, developed profitable, long-standing referral relationships, and created an innovative brand that positions us to serve the future customer. We are embarking on an exciting new growth chapter that focuses on client service excellence, caregiver engagement, technological innovation, and growth in new markets.
The Opportunity
We are a mission-driven organization that is dedicated to improving the lives of seniors as they age. We are passionate about what we do -- providing seniors and their families with a comprehensive, vetted and coordinated in-home service network that is high-touch, tech-enabled, compassionate and extremely well managed. We are in the exciting and dynamic home healthcare industry. Our market opportunity is large and growing as the baby boomers age and the home increasingly becomes the epicenter for care as consumers demand convenience and lower-cost solutions.
Job Summary:
The RN is responsible for administering the Care Plan and the patient/client's health and wellness as indicated by the Care Plan. Assures compliance with nursing/clinical standards federal, state, and local government regulations, and company policies. This role will treat patients, when appropriate and as needed for Skilled Nursing Services.
Essential Functions:
1. Follows the appropriate Care Plan in collaboration with the Director of Nursing, patient/client/caregivers, the patient/client's physician and other care team members as appropriate.
2. Performs on-site Orientation, quarterly Supervision Visits, Skill Checks and Annual Performances of home care aides in compliance with Federal, State and applicable Accrediting body Regulations and AHC Policies.
3. Provides on-going instructions to home health aides during field visits including reinforcement of Standard Precautions, Client Respect. HIPPA and Safety.
4. Review Personal Care Plans from Aging service Access Points, (ASAP), orienting aides in following the care plan as authorized by the ASAP RN.
5. Documents services rendered and changes in client conditions and/or family and home situation.
6. Communicates with ASAP Case Managers or client's legal representative/family any concerns or issues regarding client status as necessary.
7. Performs other duties as assigned.
Knowledge, Skills and Abilities:
  • Excellent problem-solving ability; organizational skills and requires minimal direction.
  • Demonstrated competence in applying processes designed to ensure adherence to all pertinent federal and state rules and regulations.
  • Strong communication skills. Possess the ability to clearly and effectively communicate with staff, physicians, referral sources, patients and their families.
  • Demonstrated computer literacy skills.
Qualifications:
Required
  • Graduate of an approved school of professional nursing.
  • Current licensed Registered Nurse in practicing state.
  • One or more years of experience and responsibilities in clinical home health services, or equivalent preferred.
  • Must be a licensed driver in the appropriate state and have available independent transportation with current insurance coverage.
Preferred
  • Current CPR certification.

Make a difference in the life of a senior. Apply now!
Pay Range: The hiring range for this position is $39-$41/Hourly. Various factors will determine final compensation such as a candidate's years of relevant work experience, skills, certifications, and location.
AHCOS1000
HouseWorks, LLC and its Family of Companies is an Equal Opportunity Employer. We do not discriminate against race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability or genetic information.

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