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Pre Certification Coordinator Jobs (NOW HIRING)

Washington University of St. Louis

$21.33 - $31.98/hr

Documents when pre-certification is received from insurance companies. * Performs other duties as assigned. Working Conditions: Job Location/Working Conditions: * Normal working environment.

Insight Global

Pre-Certification Specialist

Charlotte, NC · On-site

$22 - $28/hr

Pre-Certification Specialist Location: Charlotte, NC 28210 Hours: Mon-Fri, 8am-5pm Must Haves: * 3+ ... The role is heavily focused on coordinating outpatient surgeries, managing scheduling logistics ...

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How much do pre certification coordinator jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for pre certification coordinator in the United States is $19.87, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $20.91 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a pre certification coordinator, and why are they important?

To thrive as a Pre Certification Coordinator, you need a solid understanding of insurance processes, medical terminology, and prior authorization procedures, often supported by a background in healthcare administration or a related field. Familiarity with electronic medical records (EMR) systems, insurance portals, and authorization management software is typically required. Excellent organizational skills, attention to detail, and effective communication are crucial soft skills for managing high volumes of requests and collaborating with healthcare providers and payers. These competencies ensure accurate, timely approvals that optimize patient care and reimbursement processes.

How does a pre certification coordinator typically interact with healthcare providers and insurance companies?

As a Pre Certification Coordinator, you'll frequently communicate with both healthcare providers and insurance companies to ensure that required pre-authorizations for medical procedures are obtained promptly. This involves verifying patient coverage, gathering necessary clinical documentation, and following up on pending authorizations. Strong organizational and communication skills are essential, as you may need to clarify requirements with providers or resolve discrepancies with insurance representatives. Building positive relationships and maintaining clear records can help streamline the approval process and minimize delays for patients.

What is a pre certification coordinator?

Pre Certification Coordinators are healthcare professionals responsible for obtaining prior authorizations and ensuring that medical procedures, treatments, or hospital admissions are approved by insurance providers before services are rendered. They work closely with healthcare providers, patients, and insurance companies to verify coverage, gather necessary documentation, and facilitate timely approvals. Their work helps reduce claim denials, ensures compliance with insurance requirements, and supports smooth patient care delivery.

What is the difference between Pre Certification Coordinator vs Certification Specialist?

AspectPre Certification CoordinatorCertification Specialist
Required CredentialsTypically requires healthcare or industry-specific certifications, knowledge of certification processesOften requires similar certifications, with additional focus on certification standards and compliance
Work EnvironmentHealthcare facilities, insurance companies, or industry organizationsRegulatory agencies, healthcare organizations, or certification bodies
Employer & Industry UsageUsed in healthcare, construction, or manufacturing sectors for pre-approval processesCommon in healthcare, quality assurance, and compliance sectors

The Pre Certification Coordinator and Certification Specialist roles both involve certification processes, but the Coordinator typically manages pre-approval activities, while the Specialist focuses on certification standards and compliance. Both roles require similar credentials and are found in related industries, often overlapping in healthcare and regulatory environments.

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What states have the most Pre Certification Coordinator jobs?

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Pre Certification Coordinator jobs near you
Infographic showing various Pre Certification Coordinator job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 74% Full Time, 17% Part Time, and 7% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $41,322 per year, or $19.9 per hour.

Referral/Pre-Certification Coordinator (8a-430p) - Big Stone Gap, VA

Ballad Health

Big Stone Gap, VA • On-site

$16.25 - $23.13/hr

Full-time

Posted 24 days ago

Ballad Health rating

6.5

Company rating: 6.5 out of 10

Based on 228 frontline employees who took The Breakroom Quiz

605th of 887 rated healthcare providers

Job description

Job Description:
Summary:
The Referral/Pre-Certification Coordinator Verifies and updates patient registration information in Epic. Obtains benefit verification and necessary authorizations (referrals, precertification) prior to patient arrival for all ambulatory visits, procedures, injections, and radiology services. Act as liaison between health plan and physician and/or clinic staff regarding patient complaints and patient non-compliance. Effectively communicate, collaborate, and interact with patients\plan members, multiple levels of internal personnel and external customers. Use complete knowledge of various insurances and stays current on constantly changing requirements, contracted plans, and any other pertinent information pertaining to referrals. Utilize online, web-based verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility. Create appropriate referrals to attach to pending visits. Verify patient demographic information and insurance eligibility including coordination of benefits; update and confirm as necessary to allow processing of claims to insurance plans. Complete chart prepping tasks daily to ensure smooth check-in process for the patient and clinic. Research all information needed to complete registration process, obtaining information from clinicians, ancillary services, and patients. As needed, fax referral/authorization form(s) to PCPs and insurance companies in a timely manner. Review and notify front office staff of outstanding patient balances. Maintain satisfactory productivity rates and ensure the timeliness of claims reimbursement while maintaining work queue goals. Responsible for handling the collection and documentation of patient referrals from BHMA physicians for specialist care to obtain the necessary approval, preauthorization, precept, or referral from the managed care companies or other parties requiring authorization.
Respond to In-house clinician and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination or follow-up status. Identify and communicate trends and/or potential issues to management team. Index referrals to patient accounts for existing patients. Create new patient accounts for non-established patients to index referrals.
Various duties as they arise.
Requirements:
Education/Experience:
Required - High School Graduate and 2 years' prior experience in the medical field.
Knowledge/Skills Abilities:
Excellent phone etiquette - verbal, written and listening skills. Must have strong customer service skills, demonstrating tact and sensitivity in stressful situations. Knowledge of medical terminology and CPT, HCPCS and ICD coding. Prior experience utilizing electronic medical records. Ability to maintain confidentiality and observe HIPAA compliance. Be able to process 60-80 referrals daily.
Preferred:
Associates Degree or bachelor's degree in Healthcare or Business-related field.
Work Requirements:
Shift: Day
On Call: No
Weekends: No
Travel Required: No Travel
Shift Details: 8a-430p
City/State: Big Stone Gap, VA
The range for this position is $16.25-$23.13. Actual rate is dependent upon experience.
Location:
Ballad Health Medical Associates

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About Ballad Health

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Become a part of the Ballad Health story. Together, we are transforming our region. We're making communities healthier. We're expanding access to critical services in rural areas.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Johnson City, TN, US

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