This is a temporary, limited tenure position with an anticipated end date in December 2020.
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. This is for a position with our Transplant Precertification department.
Minimum Education: High School Diploma or GED required
Minimum Experience: 2+ years of relevant experience required OR 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 $20.95 per hour.
Hours / Pay period
Monday-Friday between the hours of 8am and 5pm, 40 hours per week
Over the next four years, Mayo Clinic is making significant investments in both the physical and technological future of health care, through doubling the size of the Mayo Clinic campus in Phoenix, inclusive of practice, education, and research activities. Mayo Clinic's campuses in Arizona are located in Phoenix and Scottsdale, in the beautiful Sonoran Desert. The region is known as the Valley of the Sun, a metropolitan area with more than 4 million residents in 25 cities and towns.
With Phoenix being the sixth largest city in the nation, this sunny "desert metropolis" offers the amenities of a big city in the midst of a strikingly beautiful, rugged, southwest landscape.
Scottsdale frequently earns praise as a highly desirable place to live. The city's more than 200,000 residents enjoy a vibrant mix of culinary hot spots, arts and entertainment, professional and collegiate sports teams, and community resources. The region's desert climate promotes an outdoor lifestyle with a full complement of sports and recreation.
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).