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Precertification Analyst Jobs (NOW HIRING)

OpTech

RN Precertification Analyst

Detroit, MI · On-site

Detroit, MI Registered Nurse (RN) Contract We are seeking a Michigan RN - Remote Utilization Management: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory ...

CYNET SYSTEMS

Precertification Coordinator

Houston, TX · On-site

$24/hr

Minimum 2+ years of experience in working in precertification. * Working knowledge of managed care ... Familiarity with ICD-9 and ICD-10. * Strong analytical skills with the ability to assess and ...

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

Job Title: Precertification Specialist Location: Smyrna, GA Compensation: $22.00 per hour ... Analytical thinkers who can research and resolve complex authorization issues. * Good listeners who ...

Addison Group

Precertification Specialist

Smyrna, GA · On-site

$22/hr

Precertification Specialist Location: Smyrna, GA Compensation: $22.00 per hour Employment Type ... Analytical thinkers who can research and resolve complex authorization issues. * Good listeners who ...

Borland Groover

Precertification Specialist

Jacksonville, FL · On-site

$15.25 - $19/hr

POSITION SUMMARY The Precertification Specialist at Borland Groover is a part of the Patient Access ... Analyzing: essential * Logic: essential * Verbal communication: essential * Written communication ...

Infirmary Health

Insurance Verification/Precert LPN

Mobile, AL · On-site

$25.50 - $34.75/hr

Uses clinical expertise to analyze insurance medical necessity requirements and benefits via provider website to ensure requirements are met for referrals/precertification to be submitted according ...

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Precertification Analyst information

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$29.5K

$71.5K

$123K

How much do precertification analyst jobs pay per year?

As of Sep 14, 2026, the average yearly pay for precertification analyst in the United States is $71,511.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,500.00 and $79,000.00 per year, depending on experience, location, and employer.

What is a precertification analyst?

A Precertification Analyst is a healthcare professional responsible for reviewing medical procedures, tests, or hospital admissions to determine if they meet insurance policy requirements before they are performed. They work with healthcare providers, insurance companies, and patients to ensure that necessary authorizations are obtained and that the services are covered. Their role helps prevent insurance claim denials and ensures compliance with healthcare regulations. Precertification Analysts must have strong attention to detail, knowledge of medical terminology, and the ability to interpret insurance guidelines.

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

To thrive as a Precertification Analyst, you need a solid understanding of healthcare insurance processes, medical terminology, and prior authorization requirements, often supported by experience in medical billing or certification in healthcare administration. Familiarity with insurance verification systems, electronic health records (EHR), and claims management software is typically required. Attention to detail, strong organizational skills, and effective communication help analysts efficiently handle complex cases and collaborate with providers and payers. These skills are crucial to ensure timely and accurate precertification approvals, reducing claim denials and supporting patient access to necessary care.

What are some common challenges faced by precertification analysts, and how can they be managed effectively?

Precertification Analysts often encounter challenges such as managing a high volume of requests, navigating complex insurance policies, and ensuring timely communication between healthcare providers and insurance companies. Staying organized and utilizing electronic health record (EHR) systems can help streamline workflows. Building strong relationships with clinical staff and insurance representatives also aids in resolving issues quickly. Continuous learning about evolving insurance guidelines is essential to stay effective in this role.

What is the difference between Precertification Analyst vs Claims Processor?

AspectPrecertification AnalystClaims Processor
Required credentialsHigh school diploma or equivalent; certifications like CPC or CCS may be preferredHigh school diploma or equivalent; certifications are less common
Work environmentHealthcare offices, insurance companies, or hospitalsInsurance companies, healthcare providers, or billing departments
Employer and industry usageUsed in health insurance and healthcare settings to review prior authorizationUsed in insurance and healthcare to process and review claims for payment

While both roles are involved in healthcare billing and insurance processes, a Precertification Analyst primarily reviews and authorizes procedures before treatment, whereas a Claims Processor handles the billing and reimbursement after services are provided. Understanding these differences helps clarify career paths and employer expectations in the healthcare insurance industry.

What cities are hiring for Precertification Analyst jobs?

Cities with the most Precertification Analyst job openings:

What states have the most Precertification Analyst jobs?

States with the most job openings for Precertification Analyst jobs include:

What are popular job titles related to Precertification Analyst jobs?

For Precertification Analyst jobs, the most frequently searched job titles are:

Infographic showing various Precertification Analyst job openings in the United States as of August 2026, with employment types broken down into 86% Full Time, and 14% Temporary. Highlights an 100% In-person job distribution, with an average salary of $71,511 per year, or $34.4 per hour.

RN Precertification Analyst

Detroit, MI • On-site

OpTech
See more jobs at OpTechexternal

Other

Retirement

Posted 16 days ago

Job description

Detroit, MI
Registered Nurse (RN)
Contract
We are seeking a Michigan RN - Remote Utilization Management:
Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments.
Requirements:

  • RN - unrestricted Michigan Registered Nurse license required
  • 2-4 years of clinical experience - acute patient care, discharge planning, case management, and utilization review
  • Clinical experience in ICU, ER, or medical surgical unit preferred .
  • Utilization management experience preferred
  • 1 year health insurance plan experience or managed care environment preferred.
  • Computer - MS Office, Type 35+WPM, Dual monitors, multiple systems
  • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.

Why work with us? We are a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work with us you'll have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! We are an EOE, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. https://www.optechus.com/eeo_self_identification/

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