Operations Analyst III- Prior Authorization Denials-Remote

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.

Benefits Highlights

• 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.
  
  

Responsibilities

Analyzes and interprets data to initiate and facilitate implementation of solutions for process, quality and procedural improvements within the Enterprise Revenue Cycle and Mayo Clinic by understanding Enterprise Revenue Cycle operations, processes, systems, regulations, clinical practice, payer changes and data. Analyzes, designs, and redesigns processes, workflow, and systems to ensure quality, effectiveness and efficiency, identifies resource impact, and manages the implementation cycle. Leads and facilitates process improvements by understanding system dependencies. Participates in the design, development, testing, implementation, training and maintenance of new business process and system applications with Systems Services staff; coordinating operational input and resources. Leads effective meetings, workgroups, and committees which include participants throughout Mayo Clinic to facilitate and negotiate issues with institutional impact. Specifies and acquires resources for project completion. May serve as primary resource for Enterprise Revenue Cycle. Possesses ability to make appropriate decisions regarding complex operational issues having an Enterprise Revenue Cycle or Mayo Clinic impact. Interacts collaboratively with various departments to support and direct activities and work flows. Collaborates with leadership to resolve Enterprise Revenue Cycle issues. Partners with appropriate areas to ensure compliance with federal and state requirements. Works with external vendors and/or internal stakeholders as a subject matter expert to

analyze issues and resolutions. Mentors and develops staff. Maintains knowledge of current healthcare environment. May need to present before local, state and national conferences and user group meetings. Ensures changed processes are incorporated into training and internal control materials for Enterprise Revenue Cycle staff and other users. Provides regular updates to senior leadership. Solicits and makes key decisions. May provide direct supervision to staff. Understands and is accountable for ensuring a control environment is maintained to preserve Mayo's Standard of Ethics and minimize the financial and legal risks for Mayo. May work evening and weekend hours and travel as needed.

Qualifications

Bachelors with 7 years of relevant experience

OR

Masters with 3 years relevant experience.

Relevant experience is considered in Finance Revenue Cycle, or Healthcare.

The preferred applicant will have previous experience in prior authorization, reviewing prior authorization denials, data analysis as it pertains to denials.

Preferred knowledge and experience in Project Management. Extensive knowledge of physician and hospital billing systems for Governmental, managed care and commercial payers. Customer-service oriented, timely in responses to requests for service/information, able to manage multiple tasks and priorities, have the ability to work independently and possess leadership skills. Requires knowledge of revenue cycle systems. Healthcare Financial Management Association (HFMA) Certification Preferred.

• This position is a 100% remote work. Individual may live anywhere in the US.
• This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
  
  

Exemption Status

Exempt

Compensation Detail

$74,859 - $110,052 / year

Benefits Eligible

Yes

Schedule

Full Time

Hours/Pay Period

80

Schedule Details

Standard Days M-F

Weekend Schedule

N/A

International Assignment

No

Site Description

Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" . Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

Recruiter

Ronnie Bartz