Prior Authorization & Denials Coordinator - Full-Time | Days

Prior Authorization & Denials Coordinator - Full-Time | Days

The Staff Pad has partnered with a reputed healthcare organization in Las Vegas, New Mexico to find a dedicated Prior Authorization & Denials Coordinator to join their Registration/Patient Access Team.

The Prior Authorization & Denials Coordinator is responsible for managing prior authorizations for medical services, procedures, and medications, as well as overseeing denied claims to ensure timely reimbursement.

This role serves as a liaison between healthcare providers, insurance companies, and patients—helping to ensure that authorization requirements are met and denials are resolved efficiently.

Schedule: Full-Time | Days

What You’ll Do

Key Responsibilities

• Prior Authorizations

• Obtain prior authorizations for outpatient procedures, diagnostic testing, and specialty medications

• Verify insurance eligibility, benefits, and authorization requirements for scheduled services

• Communicate with insurance companies, physician offices, and patients to secure required documentation

• Track pending authorizations and follow up to ensure timely approvals

• Denials Management

• Review and analyze denied claims to determine root causes and appeal opportunities

• Prepare and submit appeals with appropriate documentation and clinical justification

• Collaborate with billing, coding, and clinical teams to gather necessary information for appeals

• Track status and outcomes of appeals, maintaining organized records

• Maintain strict confidentiality of all patient and financial information

• Communication & Coordination

• Provide updates to providers, staff, and patients regarding authorization and denial statuses

• Educate internal teams on authorization and denial best practices

• Serve as a subject matter expert for payer-specific policies and insurance guidelines

• Compliance & Reporting

• Ensure compliance with payer policies, HIPAA, and regulatory standards

• Maintain accurate records and logs for audits and quality assurance

• Generate regular reports on authorization status, denial trends, and appeal outcomes

• What We Are Looking For

• Education & Experience

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred

• 2+ years of experience in healthcare billing, utilization management, or a medical office setting

• Prior experience with authorization and denial management is strongly preferred

• Previous Acute care hospital experience preferred

• Skills & Competencies

• Knowledge of insurance carriers, medical terminology, and coding (CPT, ICD-10)

• Excellent organizational and multitasking skills

• Strong written and verbal communication abilities

• Proficient in EHR systems, practice management software, and Microsoft Office

• Detail-oriented with strong problem-solving and analytical skills

• What You Can Expect

• Exceptional patient care starts with a team that feels valued, supported, and empowered - backed by comprehensive compensation and benefits every step of the way

Benefits

• Medical, Rx, Dental, Vision, Life & AD&D Insurance

• Retirement Plans

• PTO, Leave of Absence

• Maternity/Disability Leave

• Flexible Spending Account

• If you are an organized, detail-oriented professional with experience in healthcare authorizations and denials management, we encourage you to apply and become part of a team committed to delivering quality patient care.