Family Medicine Prior Authorization Nurse (RN/LPN)

York-General-1; York (NE); On-site; USD 52,000 - 74,000; Full time

Job summary

York General invites applications for a Family Medicine Prior Authorization Nurse (LPN or RN) on a full-time basis. You will coordinate insurance prior authorizations for medications, procedures, diagnostics, and equipment to ensure timely patient access, collaborating with providers, pharmacies, insurers, and patients.

The role requires an accredited nursing degree, at least one year of nursing experience, and solid skills in organization, communication, and EMR use.

Qualifications

• Graduate of an accredited nursing program.
• Minimum of one year of nursing experience.
• Ability to interpret clinical documentation and payer requirements.
• Proficiency with EMR and healthcare technology systems.

Responsibilities

• Review provider orders, treatment plans, and documentation to determine authorization requirements.
• Submit and manage prior authorization requests for medications, procedures, testing, and other services.
• Communicate with insurance companies regarding coverage determinations, denials, appeals, and requirements.
• Coordinate with providers, clinic staff, pharmacies, and patients to support access to care.
• Manage denial appeals, reconsiderations, and peer-to-peer review processes.
• Maintain accurate documentation within the EMR.
• Stay current on payer requirements and best practices; monitor outcomes.

Skills

Organizational skills

Self-motivated

Detail-oriented

Communication

Critical thinking

Time management

Education

Nursing degree/diploma

Tools

Electronic Medical Records (EMR)

Job description

York General invites applications for a Family Medicine Prior Authorization Nurse (LPN or RN) on a full-time basis. You will coordinate insurance prior authorizations for medications, procedures, diagnostics, and equipment to ensure timely patient access, collaborating with providers, pharmacies, insurers, and patients.

The role requires an accredited nursing degree, at least one year of nursing experience, and solid skills in organization, communication, and EMR use.