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Precertification Analyst Jobs (NOW HIRING)

Ascension Seton - Austin

RN - Case Manager

Austin, TX · On-site

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

New

Elevance Health

Utilization Management Rep I (US)

... for precertification and prior authorization review. How you will make an impact: * Managing ... and analytical skills. Job Level: Non-Management Non-Exempt Workshift: Job Family: CUS > Care ...

New

United Musculoskeletal Partners

Surgery Scheduler

Addison, TX · On-site

$18.25 - $23.50/hr

Enters benefits and precertification/authorization into EMR system (Referral Management ... Background in medical terminology, Orthopedics/Spine, and ability to analyze medical situations for ...

Texas Spine Consultants

Surgery Scheduler

Addison, TX · On-site

$18.25 - $23.50/hr

Enters benefits and precertification/authorization into EMR system (Referral Management ... Background in medical terminology, Orthopedics/Spine, and ability to analyze medical situations for ...

United Musculoskeletal Partners

Surgery Scheduler

Addison, TX · On-site

$18.25 - $23.50/hr

Enters benefits and precertification/authorization into EMR system (Referral Management ... Background in medical terminology, Orthopedics/Spine, and ability to analyze medical situations for ...

Resurgens Orthopaedics

Surgery Scheduler

Addison, TX · On-site

$18.25 - $23.50/hr

Enters benefits and precertification/authorization into EMR system (Referral Management ... Background in medical terminology, Orthopedics/Spine, and ability to analyze medical situations for ...

Resurgens Orthopaedics

Surgery Scheduler

Addison, TX · On-site

$18.25 - $23.50/hr

Enters benefits and precertification/authorization into EMR system (Referral Management ... Background in medical terminology, Orthopedics/Spine, and ability to analyze medical situations for ...

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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 15, 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 - Case Manager

Austin, TX • On-site

Ascension Seton - Austin
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Other

Posted 3 days ago

New

Job description

RN Utilization Review

Provides health care services regarding admissions, case management, discharge planning, and utilization review. Reviews admissions and service requests for prospective, concurrent, and retrospective medical necessity and compliance with reimbursement policy criteria. Provides case management and consultation for complex cases. Assists departmental staff with coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals. Assesses and coordinates discharge planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance with federally mandated and third-party payer utilization management rules and regulations. Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment. Centralized acute admission utilization review across various care settings.

Minimum 2 years in acute care utilization management or equivalent License: Licensed RN (multistate or Texas RN) Certifications: BLS Must-Have: - Proficiency with InterQual/MCG and CMS regulations. - Experience with payor portals, managed Medicare and Medicaid insurers. - Proficient and adaptable in using multiple technologies simultaneously. - Remote work experience preferred.

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