Precertification and Authorization Rep-.4 FTE-Hybrid

Mayo Clinic•Rochester, MN

1d•$22 - $34•Hybrid

About The Position

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed.

Requirements

High School Diploma or GED and 2+ years of relevant experience required OR Bachelor’s degree required
Ability to read and communicate effectively
Basic computer/keyboarding skills, intermediate mathematic competency
Good written and verbal communication skills
Knowledge of proper phone etiquette and phone handling skills
Position requires general knowledge of healthcare terminology and CPT-ICD10 codes.
Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view.
Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail.

Nice To Haves

Basic knowledge of and experience in insurance verification and claim adjudication is preferred.
Knowledge of Denial codes is preferred.
Knowledge of and experience using an Epic RC/EMR system is preferred.
Healthcare Financial Management Association (HFMA) Certification Preferred.

Responsibilities

This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs.
The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments.
This position may be responsible for pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department.
This may include processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, as well as working assigned registration denials for government and non-government accounts.
This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations.