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Pre Certification Jobs in Tennessee (NOW HIRING)

RAYUS Radiology

Insurance Specialist

Clarksville, TN · On-site

As an Insurance Specialist, you will be responsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify ...

Covenant Health

PATIENT REGISTRATION SPEC

Morristown, TN · On-site

$16 - $22/hr

Ensures verification of benefits and pre-certification requirements are met prior to scheduled appointment/admission. Follows up as necessary on all urgent or unscheduled registrations for ...

Covenant Health

PATIENT REGISTRATION SPEC

Morristown, TN · On-site

$16 - $22/hr

Ensures verification of benefits and pre-certification requirements are met prior to scheduled appointment/admission. Follows up as necessary on all urgent or unscheduled registrations for ...

RAYUS Radiology

Insurance Specialist

Clarksville, TN · On-site

As an Insurance Specialist, you will be responsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify ...

Rayus Radiology

Insurance Specialist

Clarksville, TN · On-site

As an Insurance Specialist, you will beresponsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance ...

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All JobsPre Certification JobsPre Certification Jobs in Tennessee

Pre Certification information

What is a pre certification specialist?

A Pre Certification specialist is a healthcare professional responsible for obtaining approval from insurance companies before certain medical procedures, treatments, or hospital admissions. Their job involves verifying patient insurance coverage, submitting necessary documentation, and communicating with both healthcare providers and insurers to ensure services are authorized. This process helps prevent unexpected costs for patients and ensures compliance with insurance requirements. Pre Certification specialists play a crucial role in streamlining patient care and reducing claim denials.

What are some common challenges faced in a pre certification role and how can they be managed effectively?

Professionals in Pre Certification often encounter challenges such as navigating complex insurance requirements, managing high volumes of authorization requests, and staying up-to-date with frequent policy changes. Effective communication with healthcare providers and insurance companies is essential to ensure timely approvals and minimize delays in patient care. Developing strong organizational skills, leveraging electronic health record (EHR) systems, and participating in regular training can help manage these challenges and improve workflow efficiency.

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

To thrive as a Pre-Certification Specialist, you need a solid understanding of medical terminology, insurance policies, and healthcare procedures, often supported by a background in healthcare administration or medical billing. Familiarity with pre-authorization systems, electronic health records (EHRs), and payer portals is typically required. Excellent attention to detail, organizational skills, and effective communication are crucial soft skills for this role. These competencies are essential to ensure accurate, timely insurance approvals and to facilitate uninterrupted patient care and reimbursement.

What is the difference between Pre Certification vs Certified Technician?

AspectPre CertificationCertified Technician
Required CredentialsTypically no formal certification required, often an entry-level or preparatory statusRequires specific certifications or licenses, demonstrating proficiency
Work EnvironmentTraining settings, entry-level roles, or preparatory stagesActive work in the field, performing technical tasks
Employer UsageUsed to indicate readiness for certification or entry-level statusIndicates a qualified professional with verified skills

Pre Certification generally refers to an initial or preparatory status before obtaining full certification. Certified Technician signifies a professional who has met certification requirements and is qualified to perform technical tasks independently. The main difference lies in certification status and work readiness, with Pre Certification serving as a stepping stone towards full certification.

What are the most commonly searched types of Pre Certification jobs in Tennessee?

The most popular types of Pre Certification jobs in Tennessee are:

What are popular job titles related to Pre Certification jobs in Tennessee?

For Pre Certification jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Pre Certification jobs in Tennessee look for?

The top searched job categories for Pre Certification jobs in Tennessee are:

What cities in Tennessee are hiring for Pre Certification jobs?

Cities in Tennessee with the most Pre Certification job openings:

Pre Certification jobs near you
Infographic showing various Pre Certification job openings in Tennessee as of August 2026, with employment types broken down into 2% As Needed, 78% Full Time, 14% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

Referral/Pre-Certification Coordinator (7a-5p) - Kingsport, TN

Ballad Health

Kingsport, TN • On-site

$17 - $22.25/hr

Full-time

Posted 13 days ago

Ballad Health rating

6.5

Company rating: 6.5 out of 10

Based on 229 frontline employees who took The Breakroom Quiz

607th of 893 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: 7a-5p
City/State: Kingsport, TN
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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