Hybrid Precertification & Prior Authorization Specialist

Mayo Career Site UK; Rochester (MN); Hybrid; USD 52,000 - 78,000; Full time

Job summary

Mayo Clinic is seeking a Precertification and Authorization Representative in a hybrid role. You will resolve referrals, precertifications, and prior authorizations to support insurance plan requirements across hospital, ED, and clinic environments.

This intermediate level position may also perform pre-appointment insurance review and denials recovery within Patient Access, handling WC/TPL and managed care accounts as needed, with adherence to quality guidelines and productivity standards.

Responsibilities

• Resolve referral, precertification, and prior authorization for commercial, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments.
• Assist with pre-appointment insurance review (PAIR) and denials recovery within the Patient Access department.

Job description

Mayo Clinic is seeking a Precertification and Authorization Representative in a hybrid role. You will resolve referrals, precertifications, and prior authorizations to support insurance plan requirements across hospital, ED, and clinic environments.

This intermediate level position may also perform pre-appointment insurance review and denials recovery within Patient Access, handling WC/TPL and managed care accounts as needed, with adherence to quality guidelines and productivity standards.