Hybrid Precertification & Authorization Specialist

Mayo Foundation for Medical Education and Research; Rochester, Northern (MN, KY); Hybrid; USD 30,000 - 47,000; Full time

Benefits offered by this job

Medical plan options

Dental coverage

Vision plan

HSA and FSAs

Competitive retirement package

Job summary

Mayo Clinic is seeking a Precertification and Authorization Representative in Minnesota. This hybrid role supports referrals, precertification, and prior authorization across hospital and clinic settings, within the Patient Access department.

On-site expectations may arise, and the candidate should reside within 100 miles of a Mayo Clinic campus. The position requires a HS diploma or GED with 2+ years of relevant experience or a Bachelor’s degree.

Qualifications

• High School Diploma or GED required.
• Bachelor’s degree required.
• Knowledge of healthcare terminology and CPT-ICD10 codes preferred.
• Experience in insurance verification and claim adjudication preferred.
• HFMA Certification is a plus.

Responsibilities

• Resolve referral, precertification, and prior authorization across hospital, ED, and clinic environments.
• Support PAIR and denials recovery within Patient Access.
• Process precertification and prior authorization for WC/TPL, managed care, and HMOs.
• Handle assigned registration denials for government and non-government accounts.

Skills

Read and communicate effectively

Basic computer skills

Written communication

Phone etiquette

Healthcare terminology

CPT-ICD10 knowledge

Insurance verification

Claim adjudication

Epic RC/EMR experience

HFMA Certification

Education

High School Diploma or GED

Bachelor’s degree

Tools

Epic RC/EMR

Job description

Mayo Clinic is seeking a Precertification and Authorization Representative in Minnesota. This hybrid role supports referrals, precertification, and prior authorization across hospital and clinic settings, within the Patient Access department.

On-site expectations may arise, and the candidate should reside within 100 miles of a Mayo Clinic campus. The position requires a HS diploma or GED with 2+ years of relevant experience or a Bachelor’s degree.