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Prior Authorization Rn Jobs (NOW HIRING)

Curant Health

Prior Authorization Specialist

Smyrna, GA

$17.50 - $23.50/hr

The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ... Registered Pharmacy Technician Why Work for Us? We offer competitive pay, paid holidays, benefits ...

Aquent

Prior Authorization Specialist

Palo Alto, CA · On-site

$35.81 - $38.96/hr

Be authorized to work in the United States * Not require sponsorship of any kind for the duration ... Certified or Registered Pharmacy Technician (CPhT) credential or prior pharmacy experience.

Curant Health

Prior Authorization Specialist

Smyrna, GA

$18 - $24/hr

The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ... Registered Pharmacy Technician Why Work for Us? We offer competitive pay, paid holidays, benefits ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$18 - $24/hr

The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ... Registered Pharmacy Technician Why Work for Us? We offer competitive pay, paid holidays, benefits ...

Anchor Health CT

Prior Authorization Specialist

Hamden, CT · On-site

$48K - $62K/yr

Track, follow up, and document all authorization statuses to ensure timely patient access to care. * Assist providers and nurses with prior authorization questions, refill coordination, and pharmacy ...

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How much do prior authorization rn jobs pay per hour?

As of May 30, 2026, the average hourly pay for prior authorization rn in the United States is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $50.00 per hour, depending on experience, location, and employer.

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 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 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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What cities are hiring for Prior Authorization Rn jobs? Cities with the most Prior Authorization Rn job openings:
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in the United States as of May 2026, with employment types broken down into 2% As Needed, 40% Full Time, 51% Part Time, and 7% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution, with an average salary of $87,868 per year, or $42.2 per hour.
Prior Authorization Specialist (LPN/RN) (FT) | Prior Authorization | Ames | 2026-119

Prior Authorization Specialist (LPN/RN) (FT) | Prior Authorization | Ames | 2026-119

McFarland Clinic PC

Ames, IA

$17.50 - $23.50/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 15 days ago

McFarland Clinic rating

6.9

Company rating: 6.9 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

Job description

McFarland Clinic is currently accepting applications for Prior Authorization Specialist (LPN/RN) for its Ames office. Candidates should be service-oriented, a team player, and be able to provide extraordinary care, every day to our patients.

Responsibilities include: Complete and prioritize prior authorization requests received through the electronic health record, phone, fax, or payer websites, and monitor each request through final determination. Review requests for accuracy and completeness, obtain supporting clinical documentation, and submit medical records or referrals needed to expedite payer review. Communicate with providers, departments, nurse managers, and insurance representatives regarding medications, requirements, authorization status, and next steps. Review denials, identify appeal opportunities, obtain medically necessary information from providers, and submit appeals as appropriate. 

Education

  • Graduate of an accredited school of nursing

Certification/License

  • Possession of State Licensed Practical Nurse license. 
  • Possession of State Registered Nurse license.
  • Current Basic Life Support certification for Health Care Providers.
  • Mandatory Reporting of Dependent Adult and Child Abuse. 

Days: Monday - Friday

Hours: 8:00 AM - 5:00 PM

Experience

  • Preferred experience with medication prior authorizations and appeals

Pre-employment drug screen and criminal history background checks are a condition of hire.

Benefits

McFarland Clinic offers a comprehensive benefits package, including health and dental insurance, 401(k), and PTO. Click here for details. 

McFarland Clinic is central Iowa's largest physician-owned multi-specialty clinic. Join our team and join a group of caring professionals, dedicated to providing Extraordinary Care, Every Day! We value quality care and extraordinary service, trusting relationships and an exceptional workplace. Our organization has more than 75 years experience of caring for people. We welcome applicants who can help us enhance the health and well-being of our patients and communities we serve.

McFarland Clinic is an Equal Opportunity Employer
McFarland Clinic makes every effort to comply with all requirements of federal, state and local laws relating to Equal Employment Opportunity.

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