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Medical Precertification Specialist Jobs (NOW HIRING)

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

This position is eligible for medical, dental, vision, and 401(k) benefits. About the Opportunity ... Precertification Specialist for a contract-to-hire opportunity within its Revenue Cycle department.

Davis Eye Center

Precertification Specialist

Cuyahoga Falls, OH · On-site

$15.50 - $19.25/hr

Surgical Services Precertification Specialist Join Our Team! At Davis Eye Center, our mission is to ... Maintain accurate documentation within the electronic medical record and other systems. * Monitor ...

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

This position is eligible for medical, dental, vision, and 401(k) benefits. About the Opportunity ... Precertification Specialist for a contract-to-hire opportunity within its Revenue Cycle department.

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How much do medical precertification specialist jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for medical precertification specialist in the United States is $18.87, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.19 per hour, depending on experience, location, and employer.

What is a medical precertification specialist?

A Medical Precertification Specialist is a healthcare professional responsible for obtaining approval from insurance companies before certain medical procedures, treatments, or hospital admissions can take place. They review medical documentation, communicate with providers and insurers, and ensure that all necessary authorizations are secured to avoid claim denials. Their work helps patients receive timely care while ensuring that healthcare providers are reimbursed appropriately. This role requires strong organizational, communication, and knowledge of insurance policies and medical terminology.

What are the key skills and qualifications needed to thrive as a medical precertification specialist?

To thrive as a Medical Precertification Specialist, you need a solid understanding of medical terminology, insurance guidelines, and healthcare procedures, often supported by a high school diploma or associate degree and relevant experience. Familiarity with electronic health records (EHR) systems and insurance verification software is typically required, and some employers may prefer certification such as Certified Medical Administrative Assistant (CMAA). Attention to detail, strong organizational abilities, and effective communication are crucial soft skills in this role. These skills ensure accurate authorization of procedures, reduce claim denials, and facilitate seamless coordination between providers, insurers, and patients.

What are some common challenges faced by medical precertification specialists when obtaining insurance authorizations, and how can they be addressed?

Medical Precertification Specialists often encounter challenges such as navigating varying insurance requirements, dealing with incomplete clinical documentation, and managing tight turnaround times for authorizations. To overcome these obstacles, specialists must stay updated on payer guidelines, maintain clear communication with healthcare providers, and develop strong organizational skills to track multiple requests simultaneously. Building collaborative relationships with clinical and insurance teams can also help streamline the precertification process and ensure timely approvals.

What is the difference between Medical Precertification Specialist vs Medical Claims Processor?

AspectMedical Precertification SpecialistMedical Claims Processor
CredentialsKnowledge of insurance policies, certifications may include medical billing or codingTypically requires medical billing or coding certifications
Work EnvironmentHealthcare offices, insurance companies, hospitalsHospitals, clinics, insurance companies
Job FocusReviewing and obtaining prior approvals for proceduresProcessing and coding insurance claims after services are rendered

The Medical Precertification Specialist primarily focuses on obtaining prior approvals for medical procedures, ensuring coverage before services are provided. In contrast, the Medical Claims Processor handles the post-service billing and claims submission process. While both roles require knowledge of insurance policies and medical billing, their responsibilities and workflow differ significantly.

How do you become a medical precertification specialist?

To become a medical precertification specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of medical terminology, insurance policies, and familiarity with healthcare management software; some roles may require certification such as the Certified Professional Coder (CPC) or similar credentials.

How much does a medical precertification specialist make?

A medical precertification specialist typically earns between $40,000 and $60,000 annually, depending on experience, location, and employer. The role often requires knowledge of insurance policies and medical billing systems, with certifications like the Certified Medical Reimbursement Specialist (CMRS) enhancing earning potential.
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What job categories do people searching Medical Precertification Specialist jobs look for?

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Medical Precertification Specialist jobs near you
Infographic showing various Medical Precertification Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $39,247 per year, or $18.9 per hour.

Precertification Specialist

Columbia Orthopaedic Group

Columbia, MO • On-site

Full-time

Re-posted 4 days ago

Columbia Orthopaedic Group rating

7.5

Company rating: 7.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Description
Columbia Orthopaedic Group
Helping patients get the care they need starts before they ever arrive. If you're someone who enjoys solving insurance puzzles, staying organized, and making sure every detail is in place before care begins, you'll thrive in this role.
Why This Role Is Different
The Precertification Specialist plays a vital role in ensuring patients receive timely care by securing insurance approvals before services are provided. Working behind the scenes, you'll partner with providers, clinical teams, and insurance companies to remove barriers and keep care moving forward.
This position combines problem-solving, communication, and attention to detail to support both an exceptional patient experience and a healthy revenue cycle.
About the Role
The Precertification Specialist is responsible for obtaining prior authorizations and precertifications for medical procedures, treatments, and services. This role helps ensure patients are financially and clinically prepared for care while minimizing authorization delays and insurance denials.
Success in this role requires strong organizational skills, knowledge of insurance processes, and the ability to manage multiple priorities in a fast-paced healthcare environment.
What You Will Do
  • Submit, monitor, and follow up on prior authorization and precertification requests with insurance providers
  • Verify patient insurance eligibility, benefits, and coverage requirements prior to scheduled services
  • Review clinical documentation and collaborate with providers to ensure authorization requirements are met
  • Communicate with patients, providers, and insurance companies regarding authorization status and resolve issues as they arise
  • Research authorization denials, coordinate appeals when appropriate, and maintain accurate documentation within the electronic medical record (EMR)
  • Partner with scheduling, billing, and clinical teams to support timely approvals and reduce delays in patient care

Who Thrives in This Role
  • You enjoy solving problems and navigating complex insurance requirements
  • You are highly organized and able to manage multiple deadlines simultaneously
  • You communicate confidently with patients, providers, and insurance representatives
  • You take pride in accuracy and understand how your work supports both patients and the organization

Requirements
  • High school diploma or equivalent required
  • Minimum of two (2) years of experience in precertification, insurance verification, or medical billing required
  • Associate's or Bachelor's degree in a healthcare-related field, orthopaedic experience, or knowledge of CPT/ICD-10 coding preferred
  • Experience with electronic medical record (EMR) systems and payer portals preferred

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