RN Clinical Authorization Specialist — Prior Auth Expert

Logan Health Medical Center; Kalispell (MT); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Logan Health Medical Center seeks an experienced RN for the Clinical Authorization Specialist role. The position focuses on prior authorization and denials management for imaging across inpatient and outpatient settings.

You will partner with physicians, nursing staff, and clinic leadership to ensure medical necessity and timely approvals, while maintaining compliant documentation and effective payer communications.

Qualifications

• Montana RN license or multi-state compact with Montana authorization.
• Associate Degree in Nursing required; BSN preferred.
• Minimum 3 years of clinical nursing in acute care, ambulatory, or related healthcare settings.
• Strong knowledge of medical terminology, documentation, diagnostic testing, and reimbursement processes.
• Excellent verbal and written communication, integrity, compassion, and ability to work in teams.

Responsibilities

• Facilitate prior authorizations and medical necessity reviews for imaging services.
• Submit and track pre-certifications and authorization requests to payers.
• Review records and coordinate documentation to support appeals and denials management.
• Communicate authorization outcomes to providers and staff in a timely manner.
• Maintain accurate documentation in the EHR and relevant tracking systems.

Skills

Communication skills

Team collaboration

Attention to detail

Empathy

Critical thinking

Integrity

Education

Associate Degree in Nursing

BSN preferred

Tools

Microsoft Office Suite

EHR systems

Clinical workflow software

Job description

Logan Health Medical Center seeks an experienced RN for the Clinical Authorization Specialist role. The position focuses on prior authorization and denials management for imaging across inpatient and outpatient settings.

You will partner with physicians, nursing staff, and clinic leadership to ensure medical necessity and timely approvals, while maintaining compliant documentation and effective payer communications.