Precertification and Authorization Rep I - Remote

Company: Mayo Clinic
Location: Rochester
Posted on: November 22, 2021

Job Description:

Why Mayo ClinicMayo Clinic is the nation's best hospital (U.S. News & World Report, 2020-2021) 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, youll 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 youll 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 (https://jobs.mayoclinic.org/benefits/) . Eligibility may vary.Position descriptionThe 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 units performance expectations.QualificationsHigh School Diploma or GED and 2+ years of relevant experience requiredORBachelors Degree requiredAdditional Requirements include:Ability to read and communicate effectivelyBasic computer/keyboarding skills, intermediate mathematic competencyGood written and verbal communication skillsKnowledge of proper phone etiquette and phone handling skillsAdditional qualificationsPosition 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 certificationN/AExemption statusNon-exemptCompensation DetailRequired education, experience and tenure may be considered along with internal equity when job offers are extended. The hourly pay range is $22.54-$30.44 per hour.Benefits eligibleYesScheduleFull TimeHours / Pay period80Schedule detailsBusiness 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.Weekend scheduleOvertime and additional hours on weekend are possible based on business need.RemoteYesSite descriptionMayo 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.RecruiterVeronica BartzEOEAs 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.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.Equal opportunityAs 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.

Keywords: Mayo Clinic, Rochester , Precertification and Authorization Rep I - Remote, Other , Rochester, Minnesota