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.