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Medical Precertification Jobs (NOW HIRING)

Mercyhealth

Precertification Specialist

Janesville, WI · On-site

$17.57 - $26.36/hr

... acquire precertification. * Contacts insurance companies or employer groups to obtain pre ... One year of pre-certifications, medical billing, registration, healthcare experience, or other ...

MUSC

Lead Precertification Specialist

Charleston, SC · On-site

$16 - $19.75/hr

Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC002349 CHSCorp - Precertification Unit Pay Rate Type Hourly Pay Grade Health-20 ...

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Medical Precertification information

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$45K

$95.6K

$180K

How much do medical precertification jobs pay per year?

As of Aug 12, 2026, the average yearly pay for medical precertification in the United States is $95,625.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,000.00 and $122,500.00 per year, depending on experience, location, and employer.

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

To thrive as a Medical Precertification Specialist, you need strong knowledge of medical terminology, insurance guidelines, and healthcare documentation, usually supported by experience in medical billing or coding. Familiarity with precertification software, electronic health records (EHR) systems, and payer-specific portals is typically required. Attention to detail, effective communication, and problem-solving skills help navigate complex cases and coordinate with providers and insurers. These skills ensure timely authorization of procedures, reduce claim denials, and support efficient patient care delivery.

What are some common challenges faced by professionals in medical precertification, and how can they be managed?

Professionals in Medical Precertification often encounter challenges such as managing high volumes of authorization requests, staying updated with ever-changing insurance policies, and communicating effectively with both healthcare providers and insurance payers. To address these, strong organizational skills and attention to detail are essential, as well as ongoing training on policy updates. Building collaborative relationships with clinical staff and maintaining clear documentation can greatly help in streamlining the approval process and reducing errors.

What is medical precertification?

Medical precertification is the process of obtaining approval from a health insurance company before a patient receives certain medical services, procedures, or medications. This process ensures that the proposed care is medically necessary and covered under the patient's insurance plan. Without precertification, insurance may deny payment for the service, leaving the patient responsible for the full cost. Medical precertification is typically handled by healthcare providers or specialists who communicate with insurance companies on behalf of patients. It helps control healthcare costs and ensures appropriate use of medical resources.

What is the difference between Medical Precertification vs Medical Billing Specialist?

AspectMedical PrecertificationMedical Billing Specialist
CredentialsOften requires knowledge of insurance policies and certifications in healthcare administrationTypically requires coding certifications and billing training
Work EnvironmentHealthcare facilities, insurance companies, or third-party payersMedical offices, hospitals, or billing companies
Primary ResponsibilitiesObtaining prior approvals for procedures and treatmentsProcessing claims, coding, and billing patients and insurers

Medical Precertification focuses on securing approval for medical procedures before treatment, while Medical Billing Specialists handle the financial aspects after services are provided. Both roles are essential in healthcare administration but serve different stages of patient care and reimbursement processes.

More about Medical Precertification jobs
What states have the most Medical Precertification jobs? States with the most job openings for Medical Precertification jobs include:
What job categories do people searching Medical Precertification jobs look for? The top searched job categories for Medical Precertification jobs are:
Medical Precertification jobs near you
Infographic showing various Medical Precertification 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 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $95,625 per year, or $46 per hour.

Lead Precertification Specialist

Medical University of South Carolina

Charleston, SC

$16 - $19.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

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

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC002349 CHSCorp - Precertification Unit

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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