Prior Authorization & Precertification Specialist (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

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.