Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
Referral Coordinator/Prior Authorizations
Mount Airy, NC · On-site
$16 - $18/hr
Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
Referral Coordinator/Prior Authorizations
Mount Airy, NC · On-site
$16 - $18/hr
Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
RN Prior Authorizations
Miami, FL · On-site
... nursing admission, home care, home care infusion services, outpatient and /or inpatient elective ... Prior Authorization or concurrent review and case management experience for a health plan/managed ...
RN Prior Authorizations
Miami, FL · On-site
... nursing admission, home care, home care infusion services, outpatient and /or inpatient elective ... Prior Authorization or concurrent review and case management experience for a health plan/managed ...
Referral Coordinator/Prior Authorizations
Mount Airy, NC · On-site
$16 - $18/hr
Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
Quick apply
Referral Coordinator/Prior Authorizations
Mount Airy, NC · On-site
$16 - $18/hr
Prior authorizations are tasks within the medical field that are required to provide medications ... Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Team Lead, Prior Authorizations
Somerville, MA · On-site +1
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Team Lead, Prior Authorizations
Somerville, MA · On-site +1
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
... doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our ... Ensure prior authorization and referral requests are processed accurately and within required ...
Prior Authorizations Nurse responsibilities include speaking with providers and handling authorizations for surgery and medical services. Concurrent Review Nurse responsibilities include reviewing ...
Prior Authorizations Nurse responsibilities include speaking with providers and handling authorizations for surgery and medical services. Concurrent Review Nurse responsibilities include reviewing ...
Will be requesting prior authorization of durable medical equipment for members. 100% Telephonic ... N At least 1 years of DME experience * Preferred At least 2 years of UM experience, must have ...
Will be requesting prior authorization of durable medical equipment for members. 100% Telephonic ... N At least 1 years of DME experience * Preferred At least 2 years of UM experience, must have ...
Experienced Prior Authorizations Specialist - Pain Management
Franklin, NC · On-site
$17 - $24/hr
Associate's or Bachelor's degree in Healthcare Administration, Nursing, or related field preferred * 2+ years of experience in medical prior authorizations (pain management, orthopedics, or specialty ...
Quick apply
Experienced Prior Authorizations Specialist - Pain Management
Franklin, NC · On-site
$17 - $24/hr
Associate's or Bachelor's degree in Healthcare Administration, Nursing, or related field preferred * 2+ years of experience in medical prior authorizations (pain management, orthopedics, or specialty ...
Prior Authorization Specialist
Columbus, OH · On-site
$18.13 - $21.78/hr
Medical
Dental
Vision
Retirement
PTO
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
Prior Authorization Specialist
Columbus, OH · On-site
$18.13 - $21.78/hr
Medical
Dental
Vision
Retirement
PTO
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
Experienced Prior Authorizations Specialist - Pain Management
Boone, NC · On-site
$17 - $24/hr
Associate's or Bachelor's degree in Healthcare Administration, Nursing, or related field preferred * 2+ years of experience in medical prior authorizations (pain management, orthopedics, or specialty ...
Quick apply
Experienced Prior Authorizations Specialist - Pain Management
Boone, NC · On-site
$17 - $24/hr
Associate's or Bachelor's degree in Healthcare Administration, Nursing, or related field preferred * 2+ years of experience in medical prior authorizations (pain management, orthopedics, or specialty ...
Prior Authorization Specialist
$18.13 - $21.78/hr
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
Quick apply
Prior Authorization Specialist
$18.13 - $21.78/hr
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
Centralized Prior Authorization Nurse (RN or LPN)
Le Mars, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication within the organization. * Communication with Nurse Manager status of denials and ...
New
Centralized Prior Authorization Nurse (RN or LPN)
Le Mars, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication within the organization. * Communication with Nurse Manager status of denials and ...
New
Prior Authorization Specialist
Columbus, OH · On-site
$18.13 - $21.78/hr
Medical
Dental
Vision
Retirement
PTO
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
Prior Authorization Specialist
Columbus, OH · On-site
$18.13 - $21.78/hr
Medical
Dental
Vision
Retirement
PTO
Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...
RN Case Manager (Prior Authorizations)
San Antonio, TX · On-site
$29/hr
... authorizations into the system Qualifications - RN required - Need minimum of 2 years experience as an RN - Need Prior Auths experience! - Interqual exp A+, but will take Milliman or another similar ...
RN Case Manager (Prior Authorizations)
San Antonio, TX · On-site
$29/hr
... authorizations into the system Qualifications - RN required - Need minimum of 2 years experience as an RN - Need Prior Auths experience! - Interqual exp A+, but will take Milliman or another similar ...
Centralized Prior Authorization Nurse (RN or LPN)
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication with in the organization. * Communication with Nurse Manager status of denials and ...
New
Centralized Prior Authorization Nurse (RN or LPN)
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication with in the organization. * Communication with Nurse Manager status of denials and ...
New
Centralized Prior Authorization Nurse (RN or LPN)
Le Mars, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication with in the organization. * Communication with Nurse Manager status of denials and ...
New
Centralized Prior Authorization Nurse (RN or LPN)
Le Mars, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization of electronic medical record to efficiently process required prior authorizations and communication with in the organization. * Communication with Nurse Manager status of denials and ...
New
Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina ...
Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina ...
Prior Authorizations Nurse information
See salary details
$17.31 - $21.68
3% of jobs
$21.68 - $26.05
7% of jobs
$29.33 is the 25th percentile. Wages below this are outliers.
$26.05 - $30.42
20% of jobs
The median wage is $34.13 / hr.
$30.42 - $34.79
24% of jobs
$34.79 - $39.16
14% of jobs
$41.84 is the 75th percentile. Wages above this are outliers.
$39.16 - $43.53
11% of jobs
$43.53 - $47.90
7% of jobs
$47.90 - $52.27
5% of jobs
$52.27 - $56.64
3% of jobs
$56.64 - $61.01
3% of jobs
$61.01 - $65.38
2% of jobs
$17
$38
$65
How much do prior authorizations nurse jobs pay per hour?
What is the difference between Prior Authorizations Nurse vs Utilization Review Nurse?
| Aspect | Prior Authorizations Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, possibly certifications in case management | RN license, certifications in case management or utilization review |
| Work Environment | Healthcare facilities, insurance companies, or outpatient settings | Hospitals, insurance companies, or healthcare organizations |
| Job Focus | Securing prior approvals for treatments or procedures | Assessing medical necessity and reviewing patient cases for ongoing care |
| Common Usage | Used in insurance and healthcare to obtain treatment approval | Used in case management and quality assurance to evaluate care appropriateness |
The main difference is that a Prior Authorizations Nurse primarily focuses on obtaining approval for specific treatments or procedures before they are performed, while a Utilization Review Nurse evaluates ongoing patient cases to determine the necessity and appropriateness of continued care. Both roles require RN licensure and related certifications, but their daily tasks and focus areas differ within the healthcare and insurance industries.
What are some common challenges faced by prior authorizations nurses, and how can they be addressed?
What are the key skills and qualifications needed to thrive as a prior authorizations nurse?
What is a prior authorizations nurse?

$16 - $18/hr
Full-time
Posted 14 days ago
Job description
Description
Job Summary and Responsibilities
The referral coordinator is responsible for implementing, monitoring, and tracking of all aspects of the clinic referral processes. Prior authorizations are tasks within the medical field that are required to provide medications, medical equipment, and diagnostic imaging. Responsibilities for both aspects of this position are listed below.
Referral Coordinator duties include:
Coordination and tracking of all clinical referrals utilizing the electronic health record.
Tracking and reporting on all appropriate Patient Centered Medical Home (PCMH) standards as directed. This specifically includes the elements related to tracking referrals, and transition of care.
Work with designated staff on appropriate clinic related referral processes
Collaborate with patient and consulting providers to complete referral process
Provides the highest level of customer service to internal and external clients.
Other duties as assigned
Prior Authorization duties include:
Responsible for all aspects of the prior authorization process
Collecting all the necessary documentation
Contacting the patient for additional information to ensure completion of the required prior authorization for the prescribed medication, medical equipment and diagnostic imaging
Interacts with patients, and insurance companies as necessary, to request prior authorizations.
Provides the highest level of customer service to internal and external clients.
Other duties as assigned
Requirements
Requirements/Qualifications/Skills/Experience
Minimum of at least 2 years in primary medical care setting. At least 1 year of experience with referrals preferred. Medical certification or licensure such as CMA, LPN, or RN preferred. Proficiency with electronic health records.
About High Country Community Health
Sourced by ZipRecruiter
Industry
Outpatient health care
Company size
51 - 200 Employees
Headquarters location
Boone, NC, US
Year founded
2013