What Do Prior Authorization Nurses Do?
Wondering what the job is really like for prior authorization nurses?
You've come to the right place.
Keep reading to find detailed information about what prior authorization nurses do, including the type of work they are tasked with on a daily basis, industries in which they work, and the specific skills needed for a successful career.
Prior Authorization Nurses Overview & Description
Let's get started with the basics about prior authorization nurses by taking a look at a simple description and popular job titles.
Prior Authorization Nurses apply knowledge of healthcare and information systems to assist in the design, development, and continued modification and analysis of computerized healthcare systems. Abstract, collect, and analyze treatment and followup information of patients. May educate staff and assist in problem solving to promote the implementation of the healthcare information system. May design, develop, test, and implement databases with complete history, diagnosis, treatment, and health status to help monitor diseases.
Popular Job Titles For Prior Authorization Nurses
Sample of Reported Job Titles
- MDS Coordinators
- Health Information Specialists
- Health Information Management Technicians
- Release of Information Specialists
- Health Information Management Specialists
- MDS Coordinators/Registered Nurses
- Health Information Technicians
- Cancer Registrars
- Denials Specialists
- Medical Records Technicians
- Document Retrieval Specialists
- Prior Authorization Specialists
Read on for insight into the industries where the highest concentration of jobs for prior authorization nurses can be found.
Best Industries for Prior Authorization Nurses
Prior Authorization Nurses Jobs By Industry
- General Medical and Surgical Hospitals: 41.3%
- Offices of Physicians: 10.5%
- Education and Hospitals (Local Government): 8.4%
- Management of Companies and Enterprises: 7.6%
- Education and Hospitals (State Government): 4%
- Outpatient Care Centers: 3.4%
- Other: 24.8%
When it comes to jobs in the United States, the largest single category of prior authorization nurses can be found working in the General Medical and Surgical Hospitals sector. In 2023, about 41.3% of all jobs for prior authorization nurses were found there.
Other top industries by percentage include Offices of Physicians (10.5%), Education and Hospitals (Local Government) (8.4%), Management of Companies and Enterprises (7.6%), Education and Hospitals (State Government) (4%) and Outpatient Care Centers (3.4%).
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What Do Prior Authorization Nurses Do on a Daily Basis?
So you have a high-level understanding of what prior authorization nurses do and the types of industries in which they work - but what do they really do each day?
A great way to understand the type of work prior authorization nurses do is to examine actual job postings and focus on the specific skills that employers are seeking. That will help paint a clearer picture of the tasks that prior authorization nurses tackle each day.
Continue reading for a breakdown of specialized skills found in job postings for prior authorization nurses, as well as common skills - interpersonal qualities and attributes - that can help you thrive in the workplace.
In-Demand Skills for Today's Prior Authorization Nurses
Based on 20,225 job postings
Top 5 Specialized Skills for Prior Authorization Nurses
| Skills | Postings | % of Total Postings |
|---|---|---|
| Medical Records | 9,898 | 49% |
| Electronic Medical Record | 5,783 | 29% |
| Medicare | 3,924 | 19% |
| Nursing | 3,914 | 19% |
| Auditing | 3,744 | 19% |
Top 5 Common Skills for Prior Authorization Nurses
| Skills | Postings | % of Total Postings |
|---|---|---|
| Communication | 6,861 | 34% |
| Customer Service | 5,704 | 28% |
| Management | 4,365 | 22% |
| Detail Oriented | 3,338 | 17% |
| Writing | 3,206 | 16% |
Based on 20,225 job postings related to prior authorization nurses, medical records was the top specialized skill sought by employers, with 49% of all postings looking for that skillset. Skills for electronic medical record, medicare, nursing, auditing and medical terminology were also highly sought.
As for common skills, communication was the most desired skill found in job postings for prior authorization nurses, followed by customer service, management, detail oriented, writing and english language.
| Skill | Postings | % of Total Postings |
|---|---|---|
| Medical Records | 9,898 | 49% |
| Electronic Medical Record | 5,783 | 29% |
| Medicare | 3,924 | 19% |
| Nursing | 3,914 | 19% |
| Auditing | 3,744 | 19% |
| Medical Terminology | 3,653 | 18% |
| Health Information Management | 3,552 | 18% |
| Data Entry | 3,130 | 15% |
| Medicaid | 2,949 | 15% |
| Billing | 2,886 | 14% |
| Process Improvement | 2,292 | 11% |
| Office Equipment | 2,250 | 11% |
| Long-Term Care | 2,035 | 10% |
| Medical Privacy | 1,902 | 9% |
| ICD Coding (ICD-9/ICD-10) | 1,798 | 9% |
| Managed Care | 1,703 | 8% |
| Minimum Data Set | 1,637 | 8% |
| Workflow Management | 1,551 | 8% |
| Outbound Calls | 1,379 | 7% |
| Opening Mail | 1,342 | 7% |
| Skill | Postings | % of Total Postings |
|---|---|---|
| Communication | 6,861 | 34% |
| Customer Service | 5,704 | 28% |
| Management | 4,365 | 22% |
| Detail Oriented | 3,338 | 17% |
| Writing | 3,206 | 16% |
| English Language | 3,013 | 15% |
| Problem Solving | 2,782 | 14% |
| Leadership | 2,757 | 14% |
| Operations | 2,563 | 13% |
| Microsoft Excel | 2,493 | 12% |
| Coordinating | 2,445 | 12% |
| Microsoft Office | 2,343 | 12% |
| Computer Literacy | 2,246 | 11% |
| Clerical Works | 2,140 | 11% |
| Interpersonal Communications | 2,016 | 10% |
| Research | 1,934 | 10% |
| Organizational Skills | 1,901 | 9% |
| Administrative Functions | 1,836 | 9% |
| Lifting Ability | 1,814 | 9% |
| Filing | 1,684 | 8% |
Most In-Demand Jobs for Prior Authorization Nurses
Top 5 Posted Job Titles
| Job Title | Postings | % of Total Postings |
|---|---|---|
| MDS Coordinators | 21,434 | 45.9% |
| Health Information Specialists | 6,031 | 12.9% |
| Health Information Management Technicians | 2,605 | 5.6% |
| Release of Information Specialists | 2,114 | 4.5% |
| Health Information Management Specialists | 1,781 | 3.8% |
According to job postings that were published between September 2022 and August 2023, the top job sought by employers was mds coordinators, with 3,497 unique job postings. Health information specialists were second, with 901 postings, followed by health information management technicians, release of information specialists and health information management specialists.
Expand the section below to see unique job postings for all occupations related to prior authorization nurses.
| Job Title | Postings | % of Total Postings |
|---|---|---|
| MDS Coordinators | 21,434 | 45.9% |
| Health Information Specialists | 6,031 | 12.9% |
| Health Information Management Technicians | 2,605 | 5.6% |
| Release of Information Specialists | 2,114 | 4.5% |
| Health Information Management Specialists | 1,781 | 3.8% |
| MDS Coordinators/Registered Nurses | 3,057 | 6.5% |
| Health Information Technicians | 1,347 | 2.9% |
| Cancer Registrars | 1,026 | 2.2% |
| Denials Specialists | 1,084 | 2.3% |
| Medical Records Technicians | 704 | 1.5% |
| Document Retrieval Specialists | 608 | 1.3% |
| Prior Authorization Specialists | 755 | 1.6% |
| Health Records Technicians | 456 | 1% |
| Prior Authorization Nurses | 398 | 0.9% |
| Authorization Agents | 258 | 0.6% |
| Floaters | 882 | 1.9% |
| MDS Assistants | 706 | 1.5% |
| Medical Information Specialists | 256 | 0.5% |
| Health Information Management Managers | 524 | 1.1% |
| Clinical Reimbursement Specialists | 685 | 1.5% |
Additional Links
Ready to dig deeper into career information for prior authorization nurses? Visit our other pages focused on salary and education for prior authorization nurses.
How much do prior authorization nurses make?
Prior Authorization Nurses: How do you become one?
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