Posted in General Business 30+ days ago.
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Location: Red Wing, Minnesota
The 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.
High School Diploma or GED and 2+ years of relevant experience required
Bachelor's 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.
Education, experience and tenure may be considered along with internal equity when job offers are extended. The minimum pay rate is $18.39 per hour.
Hours / Pay period
Monday-Friday Days 8-4:30
Red Wing Minnesota, which is nestled among the bluffs, also known as the Banner County of Minnesota, is less than an hour from the St. Paul/Minneapolis metro area. Red Wing is known for its beautiful scenery and extraordinary history. The city's more than 16,000 residents enjoy a vibrant mix of healthy living activities all year round! If it's cultural and performing arts you enjoy, you'll relish in the best local, regional and national arts and entertainment! This city is truly symbolic of "Minnesota Nice!"
Administration, Business, Finance, Office & Administrative Support
Job posting number
Equal opportunity employer
Mayo Clinic is an equal opportunity educator and employer (including veterans and persons with disabilities).