Hybrid Precertification & Authorization Specialist

Mayo Clinic; Rochester (MN); Hybrid; USD 30,000 - 47,000; Full time

Benefits offered by this job

Medical plan options

Dental coverage

Vision plan

HSA/FSAs

Retirement plan

Job summary

Mayo Clinic is seeking a Precertification and Authorization Representative. The role supports insurance-specific plan requirements across inpatient, outpatient, ED, and ambulatory settings. This hybrid position requires proximity to Mayo Clinic campuses within 100 miles for on-site needs.

The position involves processing precertifications, prior authorizations, and PAIR tasks, with emphasis on accuracy and adherence to quality standards in a dynamic healthcare environment.

Qualifications

• High School Diploma or GED with 2+ years of relevant experience.
• OR Bachelor’s degree required.
• Ability to read and communicate effectively.
• Strong written and verbal communication skills.
• Knowledge of CPT-ICD10 codes and healthcare terminology.

Responsibilities

• Resolve referral, precertification, and prior authorization for all payors across hospital, ED, and clinic environments.
• Support PAIR and denials recovery within the Patient Access department.
• Process pre-certification and prior authorization for workers compensation and managed care accounts.
• Adhere to QA guidelines and productivity standards.
• Collaborate with cross-functional teams to ensure accurate insurance verification.

Skills

Communication skills

Phone etiquette

Healthcare terminology

Insurance verification

Education

High school diploma or GED

Bachelor’s degree

Tools

Epic RC/EMR

Job description

Mayo Clinic is seeking a Precertification and Authorization Representative. The role supports insurance-specific plan requirements across inpatient, outpatient, ED, and ambulatory settings. This hybrid position requires proximity to Mayo Clinic campuses within 100 miles for on-site needs.

The position involves processing precertifications, prior authorizations, and PAIR tasks, with emphasis on accuracy and adherence to quality standards in a dynamic healthcare environment.