Senior Rep - Revenue Cycle-Hybrid

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.

Responsibilities

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.

• Ensure accurate and appropriate actions to ensure payment integrity for Mayo Clinic services, requiring deep understanding of revenue cycle and payer policies and the ability to resolve complex issues.
• Handle revenue cycle activities that require deep insight into claim processes and comprehensive interpretation of payer contracts and industry standards.
• Exhibit good decision-making and judgment capabilities, attention to detail, and comfort with ambiguity.
• Be self-motivated, self-directed, highly organized, and promote a productive, collegial workplace.
• Prioritize work and handle a variety of tasks simultaneously.
• Communicate assertively with third-party payer representatives and coordinate effectively with internal areas to ensure favorable outcomes for patients and the organization.
• Continuously learn within assigned job function to support progressive responsibility.
• Interpret data, draw conclusions, review findings, and provide recommendations for improvements.
• Maintain knowledge of applicable State, Federal, and local laws/regulations, correct billing and coding requirements including industry-specific data such as modifiers, CPT, and ICD-10 coding.
• Adhere to quality assurance guidelines and established productivity standards to support the work unit’s performance expectations.
• Consistently document within the patient accounting system all actions and encounters leveraging necessary standard codes.
• Participate in special projects and other duties as directed by the Supervisor.

Qualifications

• High School Diploma or GED and 5 years of relevant healthcare, medical billing (hospital and/or professional), financial clearance, or denial management experience required. Associates degree or higher preferred.
• OR Bachelor’s degree and 1 year of relevant healthcare, medical billing (hospital and/or professional), financial clearance, or denial management experience required.
• Prior experience submitting outpatient pharmacy prior authorizations is ideal.
• C.Ph.T, LPN, or MA preferred.
• Excellent written and verbal communication skills, including proper phone etiquette.
• Advanced financial and mathematical competencies are essential.
• Analytical, problem-solving, and decision-making skills are essential.
• Advanced computer/keyboarding skills.
• Must maintain regular and acceptable attendance; may be required to work overtime.
• Competence and experience with Epic is preferred.
• Advanced knowledge of medical billing and collections processes required.
• Advanced knowledge of healthcare terminology preferred.
• Advanced knowledge of multiple payers 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.

Benefits

• Medical: Multiple plan options.
• Dental: Delta Dental or reimbursement account for flexible coverage.
• Vision: Affordable plan with national network.
• Pre-Tax Savings: HSA and FSAs for eligible expenses.
• Retirement: Competitive retirement package to secure your future.

Pay

$29.38 - $39.67 / hour

Schedule

• Full Time
• Hours/Pay Period: 80
• Schedule Details: Monday - Friday, 8am-5pm
• Weekend Schedule: As needed