Precertification and Authorization Rep-Remote

Why Mayo Clinic

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.

• 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.

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.

High School Diploma or GED and 2+ years of relevant experience required

OR

Bachelor’s degree required

Additional Requirements include:
Prior Auth / Authorization, Cancer Services, Microsoft Office, Radiation Oncology, Insurance Verification, Appeals, and Pre Determination experience preferred.

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-ICD
10 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.

Healthcare Financial Management Association (HFMA) Certification Preferred.

* This position is a 100% remote work. Individual may live anywhere in the US.

** This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.

Nonexempt

$21.48 -$33.60/ hour

Yes

Full Time

80

Monday Through Friday - 7:30 AM Mountain Time to 4:00 or 4:30 PM Mountain time. This is for the ARIZONA Location.

As needed.

No

Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives.

Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the'EOE is the Law'. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

Ronnie Bartz