What are the responsibilities and job description for the Prior Authorization & Denials Coordinator - Full-Time | Days position at The Staff Pad?
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.