In-Office Prior Authorization Specialist

Las Vegas Pain Institute and Medical Center; Las Vegas (NV); On-site; USD 42,000 - 65,000; Full time

Job summary

Las Vegas Pain Institute and Medical Center in Las Vegas, NV is seeking a dedicated Prior Authorization Specialist. You will secure insurance approvals before procedures, coordinating between physicians, patients, and insurers to ensure medical necessity and minimize claim denials.

Responsibilities include compiling records, submitting requests, tracking status, handling denials with appeals, and communicating timelines and costs to patients and providers.

Qualifications

• Familiar with medical terminology, coding systems (ICD-10, CPT, HCPCS).
• Knowledge of payer policies, Medicare/Medicaid, HIPAA compliance.
• Experience with EHR systems such as Epic or Cerner and insurance portals.

Responsibilities

• Review patient records to gather information for payer requests.
• Submit authorization requests to insurance carriers.
• Track pending requests and follow up to avoid delays.
• Investigate denials and file appeals when needed.

Skills

Medical Terminology

Insurance Knowledge

Epic or Cerner experience

HIPAA Compliance

Communication Skills

Tools

Epic/EHR systems

Insurance Portals

Job description

Las Vegas Pain Institute and Medical Center in Las Vegas, NV is seeking a dedicated Prior Authorization Specialist. You will secure insurance approvals before procedures, coordinating between physicians, patients, and insurers to ensure medical necessity and minimize claim denials.

Responsibilities include compiling records, submitting requests, tracking status, handling denials with appeals, and communicating timelines and costs to patients and providers.