The Precertification Specialist sets the precedence to ensure a positive patient experience for ... Contacts insurance plan/payers to determine eligibility, coverage information for specific ...
The Precertification Specialist sets the precedence to ensure a positive patient experience for ... Contacts insurance plan/payers to determine eligibility, coverage information for specific ...
The Precertification Specialist sets the precedence to ensure a positive patient experience for ... Contacts insurance plan/payers to determine eligibility, coverage information for specific ...
The Precertification Specialist sets the precedence to ensure a positive patient experience for ... Contacts insurance plan/payers to determine eligibility, coverage information for specific ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
Will interface between physicians, Genesis Health Group departments, and insurance organizations regarding precertification issues. Initiate and follow up on appeals for denied payments. Will ensure ...
MEDICAL RECEPTIONIST- Physical Therapy
Benton, KY · On-site
$13 - $15.75/hr
Performs insurance review by phone to obtain precertification for admission and outpatient services. Performs other duties as assigned. MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED: Excellent ...
MEDICAL RECEPTIONIST- Physical Therapy
Benton, KY · On-site
$13 - $15.75/hr
Performs insurance review by phone to obtain precertification for admission and outpatient services. Performs other duties as assigned. MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED: Excellent ...
Rooming patients, verifying demographics/pharmacy/insurance/phone * Completing vitals and properly ... Drug precertification * Checking patients out (making next appointment, entering labs/xrays)
Rooming patients, verifying demographics/pharmacy/insurance/phone * Completing vitals and properly ... Drug precertification * Checking patients out (making next appointment, entering labs/xrays)
REGISTERED/CERTIFIED CLINICAL MEDICAL ASSISTANT--RHEUMATOLOGY
Bowling Green, KY · On-site
$16.75 - $21.50/hr
Rooming patients, verifying demographics/pharmacy/insurance/phone * Completing vitals and properly ... Drug precertification * Checking patients out (making next appointment, entering labs/xrays)
REGISTERED/CERTIFIED CLINICAL MEDICAL ASSISTANT--RHEUMATOLOGY
Bowling Green, KY · On-site
$16.75 - $21.50/hr
Rooming patients, verifying demographics/pharmacy/insurance/phone * Completing vitals and properly ... Drug precertification * Checking patients out (making next appointment, entering labs/xrays)
Payer Services Specialist
Louisville, KY · On-site
$15.50 - $19.25/hr
... precertification information for the appropriate Matrix Care database fields after admission or services rendered. * Maintain a thorough understanding of all major insurance plans and network ...
Payer Services Specialist
Louisville, KY · On-site
$15.50 - $19.25/hr
... precertification information for the appropriate Matrix Care database fields after admission or services rendered. * Maintain a thorough understanding of all major insurance plans and network ...
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 ...
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 ...
Registrar
Maysville, KY · On-site
Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for ...
Registrar
Maysville, KY · On-site
Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for ...
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 ...
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 ...
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 ...
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 ...
Authorization Specialist
$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 ...
Authorization Specialist
$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 ...
Complete new admission paperwork. · Establish ability and authority of responsible party for payment of patient services rendered including precertification for patients with insurance. Perform ...
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Complete new admission paperwork. · Establish ability and authority of responsible party for payment of patient services rendered including precertification for patients with insurance. Perform ...
Clinic Clerk-Non Union
$14.75 - $18/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Clinic Clerk-Non Union
$14.75 - $18/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Clinic Clerk-Non Union Highlands
$17.75 - $21.75/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Clinic Clerk-Non Union Highlands
$17.75 - $21.75/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Clinic Clerk-Non Union
$14.75 - $18/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Clinic Clerk-Non Union
$14.75 - $18/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
CLINIC CLERK
$15.75 - $19.25/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
CLINIC CLERK
$15.75 - $19.25/hr
Contacts insurance carriers/agencies to obtain precertification of ancillary, admission and surgical procedures. * May transport patients in wheelchairs. * Operates various office equipment to ...
Insurance Precertification information
See Kentucky salary details
$22.6K - $26.3K
2% of jobs
$26.3K - $30K
7% of jobs
$30K - $33.7K
11% of jobs
$34.6K is the 25th percentile. Wages below this are outliers.
$33.7K - $37.4K
19% of jobs
The median wage is $39.7K / yr.
$37.4K - $41.1K
17% of jobs
$41.1K - $44.8K
15% of jobs
$46.3K is the 75th percentile. Wages above this are outliers.
$44.8K - $48.6K
10% of jobs
$48.6K - $52.3K
9% of jobs
$52.3K - $56K
4% of jobs
$56K - $59.7K
4% of jobs
$59.7K - $63.4K
2% of jobs
$22.6K
$42K
$63.4K
How much do insurance precertification jobs pay per year?
What is insurance precertification?
What are the key skills and qualifications needed to thrive in Insurance Precertification, and why are they important?
What is the difference between Insurance Precertification vs Insurance Authorization?
| Aspect | Insurance Precertification | Insurance Authorization |
|---|---|---|
| Definition | Process of obtaining prior approval from an insurer before certain services or procedures | General approval from an insurer for coverage of services, often after services are rendered |
| Timing | Before the service or procedure | Usually after the service has been provided |
| Required Credentials | Typically performed by insurance specialists or case managers | Handled by insurance representatives or healthcare providers |
| Work Environment | Insurance companies, healthcare facilities, or third-party vendors | Hospitals, 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?

Full-time
Re-posted 6 days ago
Job description
With more than 12,000 teammembers-physicians, surgeons, nurses, pharmacists and other highly skilled health careprofessionals-UofL Health is focused on one mission: deliveringpatient-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.