Prior Authorization & Denials Coordinator - Full-Time | Days

Company : The Staff Pad

Job Description - 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.

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Prior Authorization & Denials Coordinator - Full-Time | Days

Job Description - Prior Authorization & Denials Coordinator - Full-Time | Days

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