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Insurance Precertification Jobs in Kentucky (NOW HIRING)

UK St Claire

Post-Acute Admissions Facilitator

Lexington, KY · On-site

$19.25 - $26/hr

Essential Functions • Initiates and completes precertification and authorization requests for post-acute care services in accordance with payer requirements. • Communicates with insurance ...

ORTHOCINCY

Workers Compensation Representative

Edgewood, KY · On-site

$22 - $30.25/hr

... insurance carrier. Responsible for case management of the injured worker's claim. Address all ... Responsible for precertification and tracking of pre-certifications for all ordered tests ...

ORTHOCINCY

Workers Compensation Representative

Edgewood, KY · On-site

$35K - $40K/yr

... insurance carrier. Responsible for case management of the injured worker's claim. Address all ... Responsible for precertification and tracking of pre-certifications for all ordered tests ...

Med Center Health

Authorization Specialist

Bowling Green, KY · On-site

$17.75 - $23.50/hr

Experience in healthcare, insurance verification, prior authorization, patient access, revenue ... Reviews scheduled services and procedures to determine authorization, precertification, or other ...

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All JobsInsurance Precertification JobsInsurance Precertification Jobs in Kentucky

Insurance Precertification information

See Kentucky salary details

$22.6K

$42K

$63.4K

How much do insurance precertification jobs pay per year?

As of Jul 14, 2026, the average yearly pay for insurance precertification in Kentucky is $42,045.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,700.00 and $47,800.00 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, and why are they important?

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 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 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 are popular job titles related to Insurance Precertification jobs in Kentucky? For Insurance Precertification jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Insurance Precertification jobs in Kentucky look for? The top searched job categories for Insurance Precertification jobs in Kentucky are:
Insurance Precertification jobs near you
Infographic showing various Insurance Precertification job openings in Kentucky as of July 2026, with employment types broken down into 1% As Needed, 71% Full Time, 23% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $42,045 per year, or $20.2 per hour.
Precertification Specialist, Nucleus Building, 8:00a-4:30p

Precertification Specialist, Nucleus Building, 8:00a-4:30p

UofL Health

Louisville, KY • On-site

Full-time

Re-posted 16 days ago

Job description

Primary Location:
Nucleus Building - ULP - AMG
Address:
300 E. Market St.Louisville, KY 40202
Shift:
First Shift (United States of America)
Job Description Summary:
UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and Brown Cancer Center.
With more than 12,000 team members-physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals-UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.
The Precertification Specialist sets the precedence to ensure a positive patient experience for upcoming surgical procedures and diagnostic tests by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination and financial clearance for the hospital system and physician services for clinics, adult acute facilities and diagnostic centers.
Job Description:
Accurately and efficiently identifies all appropriate and necessary clinical documentation to support medical necessity for all scheduled procedures/medication orders for multiple service lines and clinics.
Submits authorizations and clinical information to the appropriate payer/benefit manager in a timely fashion in compliance with plan rules including appropriately utilizing the CMS IP Only list.
Assesses orders to determine appropriate patient class and works with physicians to clarify as necessary
Contacts insurance plan/payers to determine eligibility, coverage information for specific procedures and benefit information
Coordinates patient encounters using multiple systems applications, various registration applications, clinical operating systems, eligibility verification systems and medical necessity applications.
Documents all findings/communications thoroughly and accurately in the patient record.
Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
Documents all authorization information accurately in the referral as necessary to produce a clean transaction with the payer.
Answer and responds to all communications through multiple applications in a timely and professional manner to ensure a positive patient experience.
Complies with all departmental and organizational policies and procedures.
Complies with local, state, and federal rules and regulations and the requirements of accrediting bodies.
Prioritizes work according to the department, hospital, and patient needs.
Independently works to resolve patient and provider questions related to prior authorizations, referrals, and insurance verification.
Acts as a liaison between the patient, payer, provider and clinical support staff.
Responsible for managing/setting up peer to peers and/or appeals for providers in a timely and professional manner according to individual plan guidelines.
Work with all necessary parties to ensure patients are rescheduled/ notified of denials promptly.
Responsible for understanding and staying current and up to date on payer regulations.
Accurately provide expected timeframes /payer guidelines to patients and providers regarding prior authorization/ financial clearance.
Maintains compliance with all company policies, procedures and standards of conduct
Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
Performs other duties as assigned
Additional Job Description:
Education:
High School Diploma or equivalent (required)
Experience:
At least one year of patient access, insurance verification, prior authorization, or related experience (required)
3 years of prior authorization or related experience (preferred)
Medical Terminology preferred
Preferred Qualifications
Healthcare experience preferred.
Electronic Health Record experience preferred.
Knowledge of EIPC.

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