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Insurance Precertification Jobs (NOW HIRING)

Temple Health

Precertification Rep

Philadelphia, PA

$40K - $55K/yr

Responsible to confirm the financial/insurance information obtained during the registration process to determine that State, Federal and Third Party precertification/billing requirements are met to ...

Temple Health

Precertification Rep

Philadelphia, PA · On-site

$40K - $55K/yr

Responsible to confirm the financial/insurance information obtained during the registration process to determine that State, Federal and Third Party precertification/billing requirements are met to ...

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

Precertification Specialist Location: Smyrna, GA Compensation: $22.00 per hour Employment Type ... Verify patient insurance eligibility, benefits, coverage, and authorization requirements before ...

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

Job Title: Precertification Specialist Location: Smyrna, GA Compensation: $22.00 per hour ... Verify patient insurance eligibility, benefits, coverage, and authorization requirements before ...

Northside Hospital Inc.

Scheduler

Acworth, GA · On-site

$16.75 - $21.75/hr

Prior experience in insurance precertification * One (1) year secretarial experience at a healthcare organization. Work Hours: 8am-5pm

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Insurance Precertification information

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$26K

$48.4K

$73K

How much do insurance precertification jobs pay per year?

As of Aug 24, 2026, the average yearly pay for insurance precertification in the United States is $48,409.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $55,000.00 per year, depending on experience, location, and employer.

What is insurance precertification?

Insurance precertification is the process of obtaining approval from a health insurance company before a patient receives certain medical procedures, tests, or medications. This step ensures that the insurance provider agrees the proposed service is medically necessary and will be covered under the patient’s plan. Without precertification, an insurance company may deny payment for the service, leaving the patient responsible for the full cost. The process typically involves submitting clinical information and documentation to justify the need for the service. Precertification helps manage healthcare costs and ensures appropriate care from the start.

What are the key skills and qualifications needed to thrive in insurance precertification?

Success in Insurance Precertification requires knowledge of medical terminology, insurance policies, and healthcare procedures, often supported by experience in medical billing or coding. Familiarity with precertification software systems, electronic health records (EHRs), and payer portals is typically necessary. Strong attention to detail, organizational skills, and effective communication are vital soft skills for managing complex cases and collaborating with providers and insurers. These skills ensure timely and accurate insurance approvals, minimize claim denials, and support smooth patient care operations.

What are some common challenges faced in an insurance precertification role, and how can they be managed?

One common challenge in Insurance Precertification is navigating varying requirements and policies across different insurance providers, which can lead to delays or denials if not handled accurately. Staying organized, maintaining up-to-date knowledge of payer guidelines, and developing strong communication skills are essential for efficiently securing approvals. Collaborating closely with healthcare providers and insurance representatives can also help resolve issues quickly and ensure the best outcomes for patients. Many teams use specialized software systems to track requests and streamline the process, which can significantly reduce administrative burdens.

What is the difference between Insurance Precertification vs Insurance Authorization?

AspectInsurance PrecertificationInsurance Authorization
DefinitionProcess of obtaining prior approval from an insurer before certain services or proceduresGeneral approval from an insurer for coverage of services, often after services are rendered
TimingBefore the service or procedureUsually after the service has been provided
Required CredentialsTypically performed by insurance specialists or case managersHandled by insurance representatives or healthcare providers
Work EnvironmentInsurance companies, healthcare facilities, or third-party vendorsHospitals, clinics, or healthcare provider offices

Insurance Precertification involves obtaining prior approval before a procedure, while Insurance Authorization generally refers to approval after services are provided. Both are essential for insurance coverage but serve different stages in the approval process.

What does an insurance precertification specialist do?

An insurance precertification specialist reviews medical requests to determine if prior approval is needed for procedures or treatments. They verify insurance requirements, gather necessary documentation, and communicate with healthcare providers and insurance companies to ensure coverage approval before services are rendered.
More about Insurance Precertification jobs

What states have the most Insurance Precertification jobs?

States with the most job openings for Insurance Precertification jobs include:

What job categories do people searching Insurance Precertification jobs look for?

The top searched job categories for Insurance Precertification jobs are:

Insurance Precertification jobs near you
Infographic showing various Insurance Precertification job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, and 6% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $48,409 per year, or $23.3 per hour.

Insurance Precertification Specialist

Cook Childrens

Fort Worth, TX • On-site

Other

Posted 2 days ago

New

Cook Children's Health Care System rating

7.9

Company rating: 7.9 out of 10

Based on 78 frontline employees who took The Breakroom Quiz

108th of 893 rated healthcare providers

Job description

Insurance Precertification Specialist

Location: Calmont Operations Building

Department: Cardiology-Outpatient Clinic

Shift: First Shift (United States of America)

Standard Weekly Hours: 40

Summary: The Insurance Precertification Specialist will obtain insurance verification, referral authorization, processing and follow up of insurance claims and collections as required. Expected to have knowledge of all front office procedures and adhere to all policies and procedures.

Education & Experience:
  • High School Diploma.
  • 2 Years Billing and Insurance Experience.
  • 2 Years Front Office Practice Operations Experience.
  • Understanding of General Accounting Principles.

Hours: Monday to Friday: 8:00am to 4:30pm

About Us: Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.

Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.

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About Cook Children's Health Care System

Sourced by ZipRecruiter

Cook Children's Health Care System, based in Fort Worth, Texas, operates in the healthcare industry with a primary focus on pediatric health services. Established in 1918, the system has been committed to improving the health of children through the prevention and treatment of childhood diseases. This integrated pediatric healthcare system includes a medical center, physician network, home health company, research institute, and a health plan. At the core of its operations is the mission to 'Improve the Health of Every Child' in its community, reflecting its commitment to providing quality care, research, education, and prevention and wellness services.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Fort Worth, TX, US

Year founded

1918

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