Precertification and Authorization Rep I - Remote

Why Mayo ClinicMayo Clinic is the nation's best hospital (U.S. News & World Report, 2021-2022) and ranked #1 in more specialties than any other care provider. We have a vast array of opportunities ranging from Nursing, Clinical, to Finance, IT, Administrative, Research and Support Services to name a few. Across all locations, you’ll find career opportunities that support diversity, equity and inclusion. At Mayo Clinic, we invest in you with opportunities for growth and development and our benefits and compensation package are highly competitive. We invite you to be a part of our team where you’ll discover a culture of teamwork, professionalism, mutual respect, and most importantly, a life-changing career!Mayo Clinic offers a variety of employee benefits. For additional information please visit Mayo Clinic Benefits (https://jobs.mayoclinic.org/benefits/) . Eligibility may vary.Position descriptionThe Precertification and Authorization Representative I 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.QualificationsHigh School Diploma or GED and 2+ years of relevant experience requiredORBachelor’s Degree requiredAdditional Requirements include:Ability to read and communicate effectivelyBasic computer/keyboarding skills, intermediate mathematic competencyGood written and verbal communication skillsKnowledge of proper phone etiquette and phone handling skillsAdditional qualificationsPosition 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.License or certificationN/AExemption statusNon-exemptCompensation DetailRequired education, experience and tenure may be considered along with internal equity when job offers are extended. The hourly pay range is $19.46-$26.29 per hour.Benefits eligibleYesScheduleFull TimeHours / Pay period80Schedule details8:00 am - 5:00 pm Monday thru FridayWeekend scheduleN/ARemoteYesInternational AssignmentNoSite descriptionJacksonville is the largest city in area in the continental United States. A beautiful coastal Florida city that features excellent year-round climate, over 20 miles of beaches and outstanding outdoor recreational, cultural and family-oriented amenities. The “River City by the Sea” has an excellent school system, reasonable cost of living and a thriving business environment. Medical professionals and patients are drawn to Jacksonville by an extraordinary network of high-profile healthcare facilities. Jacksonville continues to grow as more people relocate from all over the U.S. and abroad, to see what the great River City has to offer!RecruiterVeronica BartzEOEAs an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.Equal opportunityAs an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.