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Prior Authorization Rn Jobs in Columbus, OH (NOW HIRING)

LMHS

Oncology Case Manager

Newark, OH · On-site

Prior authorization nurse is responsible for gathering and submitting the necessary paperwork and ... Requirements * Registered nurse with two years of experience in delivering nursing care

Oak Street Health

Registered Nurse

Columbus, OH

$60.52K - $129.62K/yr

Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...

CVS Health

Registered Nurse

Columbus, OH · On-site

$60.52K - $129.62K/yr

Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...

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How much do prior authorization rn jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for prior authorization rn in Columbus, OH is $40.80, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $48.32 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.

More about Prior Authorization Rn jobs
What are the most commonly searched types of Prior Authorization Rn jobs in Columbus, OH? The most popular types of Prior Authorization Rn jobs in Columbus, OH are:
What are popular job titles related to Prior Authorization Rn jobs in Columbus, OH? For Prior Authorization Rn jobs in Columbus, OH, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Columbus, OH look for? The top searched job categories for Prior Authorization Rn jobs in Columbus, OH are:
What cities near Columbus, OH are hiring for Prior Authorization Rn jobs? Cities near Columbus, OH with the most Prior Authorization Rn job openings:
Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Columbus, OH as of May 2026, with employment types broken down into 2% As Needed, 52% Full Time, 39% Part Time, and 7% Contract. Highlights an 95% Physical, 2% Hybrid, and 3% Remote job distribution, with an average salary of $84,871 per year, or $40.8 per hour.
RN Case Manager - Prior Authorization

RN Case Manager - Prior Authorization

Healthcare Support Staffing

Columbus, OH • On-site

$30/hr

Contractor

Posted 7 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Position Purpose: Review requests for contract specific prior authorization of services within a centralized unit

  • Review provider request for contract specific prior authorization through fax or telephone with application of evidence based criteria to ensure medical necessity for services
  • Act as clinical resource to unit referral specialist staff and make appropriate referrals
  • Provide provider education as directed
  •  Data entry and inquiry using both claims and clinical system software for performance of the authorization review process with documentation into the appropriate systems
Qualifications
Education/Experience: At least two years clinical nursing experience. Utilization review, prior authorization, or managed care experience preferred.
  • Active OH RN Licensure
  • Experienced with either Interqual or Milliman
Licenses/Certifications: Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
Additional Information

Advantages of this Opportunity:

Hours for this Position: Monday- Friday 8a-5p

Pay $30.00 per hour

Start date: 7/6

If you are interested, please call, Lovely 321-574-6539 and email your resume to me.


The greatest compliment to our business is a referral.

If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses of up to $100.00 for each placement.





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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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