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Insurance Precertification Jobs in South Carolina

Precertification Specialist-1

Charleston, SC · On-site

$16 - $19.75/hr

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient ...

Responsible for the authorization/precertification process to include coordinating with outside and internal organizations along with insurance companies to ensure prior approval requirements are met.

Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals. BENEFITS: Career development opportunities across UHS and our 300 ...

Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals. BENEFITS: Career development opportunities across UHS and our 300 ...

Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals. BENEFITS: Career development opportunities across UHS and our 300 ...

LPN-PN

West Columbia, SC · On-site

$23.75 - $32.50/hr

Staff - Patient Care, Referrals, Precertification, etc. * Understands and agrees to seek compliance ... Day ONE medical, dental and life insurance benefits * Health care and dependent care flexible ...

LPN-PN

West Columbia, SC · On-site

$19.50 - $26.25/hr

Staff - Patient Care, Referrals, Precertification, etc. * Understands and agrees to seek compliance ... Day ONE medical, dental and life insurance benefits * Health care and dependent care flexible ...

LPN-PN

Cayce, SC · On-site

$24 - $32.50/hr

Staff - Patient Care, Referrals, Precertification, etc. * Understands and agrees to seek compliance ... Day ONE medical, dental and life insurance benefits * Health care and dependent care flexible ...

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Showing results 1-20

Insurance Precertification information

See South Carolina salary details

$24.1K

$44.9K

$67.7K

How much do insurance precertification jobs pay per year?

As of Sep 5, 2026, the average yearly pay for insurance precertification in South Carolina is $44,921.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,100.00 and $51,000.00 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.
Infographic showing various Insurance Precertification job openings in South Carolina as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 18% Part Time, and 6% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $44,921 per year, or $21.6 per hour.

Precertification Specialist-1

MUSC Health & Medical University of SC

Charleston, SC • On-site

$16.25 - $20/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago


MUSC Health rating

7.0

Company rating: 7.0 out of 10

Based on 202 frontline employees who took The Breakroom Quiz

421st of 898 rated healthcare providers


Job description

Job Description Summary
MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina.
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
Entity
MUSC Community Physicians (MCP)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC004513 MCP - Revenue Cycle
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
Job Description
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.
Education: High School Degree or Equivalent
Work Experience: 1 year
Additional Job Description
Benefits:
    • Health, dental, vision, and life insurance
    • Employer Sponsored Retirement Plan
    • Paid time off and extended sick leave
    • Paid Parental Leave
    • Disability insurance plan options
    • Continuous professional and clinical training
    • Competitive pay
    • Annual Merit Increase
    • Wellbeing resources
    • Tuition Reimbursement
    • Employee perks and discounts
    • Employee referral program
    • Flexible schedule options
    • Certification incentive program

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

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About MUSC Health

Sourced by ZipRecruiter

MUSC is located in Charleston, SC, frequently named one of the best places in America to live. If charming, historic, vibrant, cultural, and coastal are adjectives that you find appealing, it's all here. In Charleston, you might find yourself dining at a world class restaurant tonight and relaxing on a boat as you explore our many waterways tomorrow. You might stroll along cobblestone streets, amidst centuries old homes by day and attend a jazz concert by night. Charleston is a place where you can live your life to its fullest.

Industry

Hospitality services

Company size

10,000+ Employees

Headquarters location

Charleston, SC, US

Year founded

1824