Precertification and Authorization Rep-Supplemental​/PRN-Hybrid

Why Mayo Clinic

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.

HYBRID: This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs.

The
Precertification and Authorization Call Center Representative is an intermediate-level role responsible for supporting referral, precertification, and prior authorization workflows within a high-volume call center environment
. This position serves as a key point of contact for insurance payers, physician offices, and patients, facilitating timely communication and coordination throughout the authorization process. While team members do not directly initiate or submit authorizations
, they provide critical operational support by managing inbound calls, addressing inquiries, gathering and communicating necessary information, and coordinating next steps with appropriate
departments and clinical practices
. Team members support more than
23 Prior Authorization specialty skills
, requiring the ability to navigate diverse workflows, systems, and departmental processes while adapting to varying customer and authorization needs. Success in this role requires strong communication and customer service skills, adaptability, attention to detail, sound judgment, and the ability to effectively manage competing priorities in a fast-paced environment. Team members are expected to consistently meet established quality, productivity, and compliance standards while maintaining a positive experience for both internal and external customers.

To support efficient and effective operations, team members are expected to maintain an average productivity rate of 6.5 calls per hour while demonstrating professionalism, accuracy, responsiveness, and exceptional customer service. Performance expectations include adherence to quality assurance standards, regulatory and compliance requirements, and departmental procedures. Ultimately, success in this role requires effectively balancing productivity with accuracy, customer satisfaction, timely resolution, and operational excellence while contributing to broader departmental goals and service standards.

High School Diploma or GED and 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-ICD
  10 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.

** This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.

During the selection process, you may participate in an OnDemand…