A large acute care health system on the Texas–New Mexico border is recruiting a bilingual (Spanish/English) Revenue Cycle Pre-Authorization Clinician to join its Memorial Campus in El Paso, TX. This is a clinically grounded, office-based role in which a licensed nurse applies utilization management expertise to secure prior payment authorizations for inpatient and outpatient services — bridging the gap between clinical necessity and payer approval. The position sits within a centralized pre-authorization and patient access support infrastructure, offering a structured, team-oriented environment for nurses who want to leverage their clinical background in a non-bedside capacity.

Perks and Benefits

Full-time employment with a large, multi-facility health system
Vaccination and screening requirements fulfilled prior to start date (COVID-19, influenza, and any future required screenings)
Reasonable accommodations provided for qualified individuals with disabilities
E-Verify participating employer — supports candidates confirming work authorization
Approximately 10% travel allowance to client and corporate office sites

Practice Highlights

Performs pre-service authorization reviews for both inpatient and outpatient services, abstracting clinical information to support medical necessity determinations
Applies nationally recognized utilization criteria alongside payer-specific authorization guidelines to communicate and document clinical justification for ordered tests, treatments, procedures, and surgeries
Coordinates directly with ordering physicians, physician office staff, facility patient access teams, and case management to obtain timely prior authorizations
Collaborates with internal and external stakeholders to identify process gaps, prevent future authorization disputes, and recommend workflow improvements to leadership
Participates in quality control audit processes and department improvement initiatives; a minimum of 2.5% of time is dedicated to quality management system activities including scorecard metric improvement
Utilizes multiple electronic tools and platforms required by both the facility and its revenue cycle partners — intermediate-to-advanced Microsoft Office proficiency (Excel and Word) required
Call center–style work environment: desk-based, computer-intensive, with telephone and standard office equipment
Approximately 10% travel to client facilities and/or corporate office locations
Regular interaction with patient access staff, case managers, physicians, and physician office staff across the facility network

Qualifications

Spanish/English bilingual proficiency required
Current, valid RN, LPN, or LVN licensure in the state of Texas (or eligibility to obtain); RN or LPN strongly preferred
Minimum 3–5 years of experience in pre-authorization or utilization review nursing within a payer or acute care setting; background in medical-surgical, critical care, or emergency department preferred
Certification as a Certified Professional in Utilization Review (CPUR), Utilization Management (CPUM), Healthcare Management (CPHM), or Certified Case Manager (CCM) preferred
Demonstrated ability to apply payer authorization criteria, conduct payer guideline research, and navigate applicable regulatory processes
Strong independent decision-making, critical thinking, conflict resolution, and multi-task prioritization skills
Ability to lift 15–20 lbs and sit at a workstation for extended periods conducting pre-service medical necessity reviews

About the Community

El Paso occupies the far western tip of Texas along the Rio Grande, directly bordering Ciudad Juárez, Mexico — making it one of the most culturally vibrant and bilingual metropolitan areas in the American Southwest. The city offers a low cost of living relative to other major Texas metros, abundant sunshine, and easy access to the Franklin Mountains State Park, White Sands National Park, and the broader Chihuahuan Desert landscape. El Paso's strong military presence (Fort Bliss), growing university community (UTEP), and tight-knit neighborhoods make it a welcoming destination for clinicians seeking an affordable, family-friendly city with deep cultural roots and outdoor recreation at the doorstep.