Precertification and Authorization Rep-.4 FTE-Hybrid

Mayo Clinic; Rochester (MN); Hybrid; USD 46,000 - 65,000; Full time

Job summary

Mayo Clinic in Rochester, MN is seeking an Insurance Authorization Specialist to ensure timely pre-authorization and coordination of benefits. This hybrid role requires proximity to Mayo Clinic campuses for on-site needs.

The position supports multiple payors across inpatient, ED and ambulatory settings, handling referrals, precertifications, and denials recovery while maintaining quality and productivity standards.

Responsibilities

• Resolve 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.
• Assist with pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department as applicable.
• Process pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, and work assigned registration denials for government and non-government accounts.
• Adhere to quality assurance guidelines and established productivity standards to support the work unit’s performance expectations.

Job description

Overview

HYBRID: This is a hybrid position and must be located within 100 miles of any Mayo Clinic campus for on-site expectations based on business needs.

Responsibilities

• Resolve 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.
• Assist with pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department as applicable.
• Process pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, and work assigned registration denials for government and non-government accounts.
• Adhere to quality assurance guidelines and established productivity standards to support the work unit’s performance expectations.