About this role
The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving 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. In addition, this position may be responsible for pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department. This may include processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, as well as working assigned registration denials for government and non-government accounts. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations.
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Other facts
About Mayo Clinic
Mayo Clinic has expanded and changed in many ways, but our values remain true to the vision of our founders. Our primary value – The needs of the patient come first – guides our plans and decisions as we create the future of health care. Join us and you'll find a culture of teamwork, professionalism and mutual respect, and most importantly, a life-changing career.
Mayo Clinic was founded in Rochester, Minnesota by brothers Dr. William James Mayo and Dr. Charles Horace Mayo. More than 100 years later, their vision continues to evolve around a single guiding value: "The needs of the patient come first." Today we are the largest integrated, not for-profit medical group practice in the world.
We are recognized for high-quality patient care more than any other academic medical center in the nation. These endorsements are very gratifying, but also humbling. They remind us of the tradition that has been entrusted to each one of us, and the legacy of excellence that we uphold every day.
What you'll do
- The Precertification and Authorization Representative resolves referral, precertification, and prior authorization issues to support insurance plan requirements. This includes processing for various payors and handling denials recovery functions.
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