Prior Authorization & Denials Specialist

The Staff Pad; Las Vegas (NV); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Retirement Plans

PTO, Leave of Absence

Maternity/Disability Leave

Flexible Spending Account

Job summary

The Staff Pad is seeking a Prior Authorization & Denials Coordinator in Las Vegas, NV for a full-time daytime schedule. The role focuses on obtaining prior authorizations, managing denied claims, and ensuring timely reimbursement for a reputable healthcare organization.

You will liaise with providers, insurers, and patients, handling documentation, appeals, and compliance while supporting a patient-access team. Prior experience and strong communication are essential.

Qualifications

• 2+ years of experience in healthcare billing or medical office settings.
• Experience with authorization and denial management is strongly preferred.
• Knowledge of insurance carriers, medical terminology, and coding (CPT, ICD-10).
• Excellent organizational and multitasking abilities.
• Strong written and verbal communication skills.
• Proficiency in EHR systems, practice management software, and Microsoft Office.
• Detail-oriented with strong problem-solving and analytical skills.

Responsibilities

• 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 documentation.
• Track pending authorizations and follow up to ensure timely approvals.
• 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.
• 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.
• 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.

Skills

Healthcare billing experience

Denial management

Insurance knowledge

Organization

Communication

EHR proficiency

Attention to detail

CPT/ICD-10 knowledge

Education

High school diploma or equivalent

Associate’s or Bachelor’s degree preferred

Job description

The Staff Pad is seeking a Prior Authorization & Denials Coordinator in Las Vegas, NV for a full-time daytime schedule. The role focuses on obtaining prior authorizations, managing denied claims, and ensuring timely reimbursement for a reputable healthcare organization.

You will liaise with providers, insurers, and patients, handling documentation, appeals, and compliance while supporting a patient-access team. Prior experience and strong communication are essential.