Precertification and Authorization Rep-Hybrid
About The Position
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. In addition, 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.
Requirements
- Intermediate level position
- Must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs.
Nice To Haves
- Pre-appointment insurance review (PAIR)
- Denials recovery functions
Responsibilities
- 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.
- Processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts.
- Working assigned registration denials for government and non-government accounts.
- Adhering to quality assurance guidelines.
- Meeting established productivity standards to support the work unit’s performance expectations.
Benefits
- Competitive compensation
- Comprehensive benefit plans
- Continuing education and advancement opportunities
- Medical: Multiple plan options.
- Dental: Delta Dental or reimbursement account for flexible coverage.
- Vision: Affordable plan with national network.
- Pre-Tax Savings: HSA and FSAs for eligible expenses.
- Retirement: Competitive retirement package to secure your future.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
