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Medical Precertification Specialist Jobs (NOW HIRING)

Working knowledge of medical billing and managed care * Background with eClinicalWorks Practice Management System preferred * Excellent communication skills to communicate with patients, physicians ...

Precertification Specialist

TN · Remote

$18 - $20/hr

Working knowledge of medical billing and managed care * Background with eClinicalWorks Practice Management System preferred * Excellent communication skills to communicate with patients, physicians ...

Working knowledge of medical billing and managed care * Background with eClinicalWorks Practice Management System preferred * Excellent communication skills to communicate with patients, physicians ...

Precertification Specialist-1

Charleston, SC · On-site

$16 - $19.75/hr

Summary MUSC Community Physicians (MCP) is an entity within the Medical University of South ... The Specialist provides detailed and timely communication to both payers and clinical partners in ...

The Outpatient Infusion (OPIC) Pre-Authorization Specialist functions under the direction of the ... Knowledge of Medicare guidelines regarding infusions that require Medical necessity checks*

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Medical Precertification Specialist information

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$26

How much do medical precertification specialist jobs pay per hour?

As of Sep 3, 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?

The top searched job categories for Medical Precertification Specialist jobs are:

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.

$18 - $20/hr

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Medical, Retirement, PTO

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Radiology Partners rating

6.6

Company rating: 6.6 out of 10

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Job description

Job Description:
JOIN PREMIER RADIOLOGY (A Radiology Partners practice): Make a local impact in the Greater Nashville, TN area!
At Premier Radiology, we believe transforming radiology starts with investing in the people who deliver care every day. As a practice of Radiology Partners (RP), Premier combines a strong local presence across Tennessee with the support and resources of a leading national radiology organization-delivering exceptional outpatient imaging while offering healthcare professionals meaningful, sustainable careers.
ABOUT PREMIER RADIOLOGY & RADIOLOGY PARTNERS, INC.
Premier Radiology is one of the leading outpatient imaging providers across Tennessee, known for convenient access, high-quality care, and an exceptional patient experience. As a proud practice of Radiology Partners (RP), Premier pairs trusted local care with the resources and clinical standards of a purpose-built national radiology organization focused on quality, access, and innovation.
With 20+ outpatient imaging centers throughout the Nashville market, Premier Radiology combines:
  • Access to hundreds of board-certified RP radiologists
  • Advanced diagnostic technology
  • Convenient, community-based locations
Together, RP and Premier Radiology are redefining how imaging supports patients, referring providers, and the clinicians who make care possible. When you join Premier Radiology, you'll be backed by Radiology Partners (RP)-a nationally recognized organization that prioritizes clinical excellence and a people-first culture.
WHY JOIN US:
  • Competitive compensation and comprehensive total rewards
  • True work-life balance in an outpatient setting-no on-call shifts or overnights
  • Consistent RP standards with local leadership and support
  • Opportunities for modality cross-training and professional growth
  • A fun, team-first culture at Premier Radiology-collaborative, supportive, and grounded in safety and trust
Radiology Partners has been Certified Great Place to Work™ for five consecutive years, reflecting the experiences of team members across our practices nationwide.
POSITION SUMMARY:
  • Will contact insurance companies and third-party administrators to determine pre-authorization and/or medical necessity requirements for outpatient radiology exams and procedures
  • Responsible for obtaining the pre-authorization before the scheduled services are performed
  • Will act as a liaison between the patients and referring physician offices when needed to obtain additional clinical documentation
  • Fully Remote - Working in CST time-zone
DESIRED PROFESSIONAL SKILLS AND EXPERIENCE:
  • Background in healthcare preferred
  • Working knowledge of medical billing and managed care
  • Background with eClinicalWorks Practice Management System preferred
  • Excellent communication skills to communicate with patients, physicians, clients, coworkers, and management staff
  • Excellent phone and computer skills
FOR MORE INFORMATION:
Learn more about this opportunity here:
Link to Job Description here.
COMPENSATION & TOTAL REWARDS:
The hourly range for this position is $18.00-$20.00. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. In addition to this range, Radiology Partners offers competitive total rewards packages, which include possible incentive and productivity programs, health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).
Final compensation is determined based on education, experience, certifications, and geographic factors.
In addition to competitive pay, Radiology Partners offers a robust total rewards package, which may include:
  • Health and wellness coverage options
  • 401(k) with employer offerings
  • Paid time off and paid holidays
  • Incentive and productivity programs (where eligible)
  • Family planning and telehealth benefits
    (All benefits subject to eligibility requirements.)

Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences.
CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.
Radiology Partners participates in E-verify.
Beware of Fraudulent Messages: Radiology Partners will never request payment, banking or other financial information in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in "@radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please email Talent@radpartners.com to notify our team.
RADIOLOGY PARTNERS OVERVIEW
Radiology Partners, through its owned and affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.
Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion, and a healthy respect for differences.
Radiology Partners participates in E-verify.

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