Hybrid Precertification & Authorization Specialist

Mayo Clinic; Rochester (MN); Hybrid; USD 30,307 - 46,838; Full time

Job summary

Mayo Clinic in Rochester, MN is seeking a Precertification and Authorization Representative. This hybrid role supports insurance pre-authorization across hospital, ED, and clinic settings and ensures timely approvals with accurate documentation in the Patient Access department.

This intermediate position requires a high school diploma or GED with 2+ years of experience or a bachelor's degree. You will resolve referrals and prior authorizations for commercial, government, and other payors, and

Qualifications

• Reading and communicating effectively.
• Basic computer and keyboard skills; intermediate mathematical competency.
• Good written and verbal communication skills.
• Knowledge of healthcare terminology and CPT-ICD10 codes.
• Experience using an Epic RC/EMR system; HFMA certification preferred.

Responsibilities

• Resolve referrals, precertification, and prior authorization for commercial, government, and other payors across hospital, ED, and clinic environments.
• Support pre-appointment insurance review (PAIR) and denials recovery functions within Patient Access.
• Process precertification and prior authorization for workers' compensation/third party liability (WC/TPL), managed care, and HMOs.
• Handle assigned registration denials for government and non-government accounts.
• Adhere to quality assurance guidelines and productivity standards.

Skills

Communication

Basic computer skills

Medical terminology

CPT-ICD10 codes

Epic RC/EMR experience

HFMA certification preferred

Education

High School Diploma or GED

Bachelor’s degree

Job description

Mayo Clinic in Rochester, MN is seeking a Precertification and Authorization Representative. This hybrid role supports insurance pre-authorization across hospital, ED, and clinic settings and ensures timely approvals with accurate documentation in the Patient Access department.

This intermediate position requires a high school diploma or GED with 2+ years of experience or a bachelor's degree. You will resolve referrals and prior authorizations for commercial, government, and other payors, and