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Precertification Analyst Jobs in Texas (NOW HIRING)

Ascension

RN-Utilization Review

Austin, TX · Remote

$84K - $118K/yr

... precertification, reimbursement and claim denials/appeals. * Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review ...

Stantec

Senior Traffic Engineer

Plano, TX · On-site

$97K - $134K/yr

Experience must include traffic operations and safety; highway capacity analysis; traffic ... TxDOT Precertification preferred This description is not a comprehensive listing of activities ...

Wje

Bridge Engineer | 15+ Years

Austin, TX · On-site

Self-performing and advising others in structural analysis, hands-on field investigation, and ... Precertification in Bridge Design with state department(s) of transportation, e.g., TxDOT Physical ...

Stantec

Senior Traffic Engineer

Plano, TX · On-site

$93K - $128K/yr

Experience must include traffic operations and safety; highway capacity analysis; traffic ... TxDOT Precertification preferred This description is not a comprehensive listing of activities ...

Ardurra

Traffic Operations Team Leader

Houston, TX · On-site

$83K - $113K/yr

Provide technical guidance on traffic operations, safety analysis, work zone traffic control, and ... TxDOT precertification or experience working under TxDOT and major municipal standards preferred

AECOM

Construction Manager

Austin, TX · On-site

Works on issues of diverse scope where analysis of situation or data requires evaluation of a ... TxDOT precertification as a Construction Superintendent. * TxDOT certifications in EMS, ACI and ...

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Precertification Analyst information

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 in Texas are hiring for Precertification Analyst jobs?

Cities in Texas with the most Precertification Analyst job openings:

Registered Nurse Utilization Review

Austin, TX • Remote

Ascension
Health Care and Social Assistance • 10K+ employees
Learn more about Ascensionexternal

$78K - $110K/yr

Full-time

Medical, PTO

Re-posted 14 days ago

Ascension Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 1,051 frontline employees who took The Breakroom Quiz

Job description

Your future role at a glance

Location: Remote

Facility: Ascension Network Services

Department: Utilization Management

Schedule: Days l Full-Time

Salary range: $78,561.60 - $110,905.60 per year (Texas) | Pay ranges vary based on candidate geographic location

How you'll make an impact in this role
  • Provide healthcare services related to admissions, case management, discharge planning, and utilization review.
  • Review admissions and service requests for medical necessity, reimbursement compliance, and utilization management criteria.
  • Support complex case management and assist staff with coding, documentation, precertification, reimbursement, and denial/appeal issues.
  • Coordinate discharge planning needs with patients, providers, and interdisciplinary healthcare teams.
  • Ensure compliance with federal regulations and third-party payer utilization management requirements while preparing reports and statistical analyses as needed.
What minimum qualifications you'll need

Licensure / Certification / Registration:

  • Licensed Registered Nurse credentialed from the Texas Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date required.

Education:

  • Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.
Life at Ascension: Where purpose meets opportunity

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.

Equal employment opportunity employer

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

Fraud prevention notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.

E-Verify statement

Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

Benefits

Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

Employment Type: OTHER

What Ascension Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Ascension

Sourced by ZipRecruiter

Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Industry

Health care and social assistance and outpatient health care

Company size

10,000+ Employees

Headquarters location

St. Louis, MO, US

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