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.
PandoLogic. Keywords: Prior Authorization Representative, Location: Las Vegas, NM - 87701