Precert and Authorization Rep
Precert and Authorization Rep
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
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 units performance expectations.
During the selection process you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview a question will appear on your screen and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
Qualifications
Minimum Education: High School Diploma or GED required
Minimum Experience: 2 years of relevant experience required OR Bachelors Degree required
Additional Requirements include:
Ability to read and communicate effectively
Basic computer/keyboarding skills intermediate mathematic competency
Good written and verbal communication skills
Knowledge of proper phone etiquette and phone handling skills
Position requires general knowledge of healthcare terminology and CPT-ICD10 codes. Basic knowledge of and experience in insurance verification and claim adjudication is preferred. Requires excellent verbal communication skills and the ability to work in a complex environment with varying points of view. Must be comfortable with ambiguity exhibit good decision making and judgment capabilities attention to detail. Knowledge of Denial codes is preferred. Knowledge of and experience using an Epic RC/EMR system is preferred. Healthcare Financial Management Association (HFMA) Certification Preferred.
Employment Type
Full-Time
