Precertification and Authorization Rep I – Remote
Why Mayo Clinic
Mayo Clinic is the nations best hospital (U.S. News & World Report, 2021-2022) and ranked #1 in more specialties than any other care provider. We have a vast array of opportunities ranging from Nursing, Clinical, to Finance, IT, Administrative, Research and Support Services to name a few. Across all locations, you’ll find career opportunities that support diversity, equity and inclusion. At Mayo Clinic, we invest in you with opportunities for growth and development and our benefits and compensation package are highly competitive. We invite you to be a part of our team where you’ll discover a culture of teamwork, professionalism, mutual respect, and most importantly, a life-changing career!
Mayo Clinic offers a variety of employee benefits. For additional information please visit Mayo Clinic Benefits. Eligibility may vary.
The Precertification and Authorization Representative I 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.
High School Diploma or GED and 2+ years of relevant experience required
Bachelor’s Degree required
Additional Requirements include:
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. Basic knowledge of and experience in insurance verification and claim adjudication is preferred. 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. Knowledge of Denial codes is preferred. Knowledge of and experience using an Epic RC/EMR system is preferred.
License or certification
$22.99 – $31.05 / hour
Hours / Pay period
100 % Remote, can work from any site.
Business hours are 7:00am – 5:00pm, Monday – Friday Central Time. Currently there are 3 rotating shifts: 7:00-3:30pm / 8:00am-4:30pm / 8:30am – 5:00pm or later based on workload. Candidate must be flexible and available during these times to cover the business need.
Overtime and additional hours on weekend are possible based on business need.
Mayo Clinic is located in the heart of downtown Rochester, Minnesota, a vibrant, friendly city that provides a highly livable environment for more than 34,000 Mayo staff and students. The city is consistently ranked among the best places to live in the United States because of its affordable cost of living, healthy lifestyle, excellent school systems and exceptionally high quality of life.
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.