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Precertification Nurse Jobs in Ohio (NOW HIRING)

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Precertification Nurse information

See Ohio salary details

$14

$34

$56

How much do precertification nurse jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for precertification nurse in Ohio is $34.32, according to ZipRecruiter salary data. Most workers in this role earn between $26.73 and $41.83 per hour, depending on experience, location, and employer.

What is a precertification nurse?

Precertification Nurses are registered nurses who review medical procedures, treatments, or hospital admissions to determine if they are medically necessary and covered by a patient's health insurance plan. They act as a liaison between healthcare providers, insurance companies, and patients, ensuring that all required documentation is complete before care is authorized. Their work helps prevent unnecessary treatments, controls healthcare costs, and ensures compliance with insurance policies. Precertification Nurses often work for insurance companies, hospitals, or managed care organizations.

What are some common challenges a precertification nurse faces when coordinating with insurance providers?

One common challenge Precertification Nurses encounter is navigating varying insurance policies and requirements, which can change frequently and differ between providers. This often involves detailed communication with both patients and insurance representatives to ensure all necessary documentation is submitted for timely approvals. Additionally, managing high volumes of precertification requests while maintaining accuracy and meeting deadlines can be demanding. Effective organization, attention to detail, and strong interpersonal skills are essential to succeed in this fast-paced environment.

What are the key skills and qualifications needed to thrive as a precertification nurse, and why are they important?

To thrive as a Precertification Nurse, you need a solid clinical background, expert knowledge of insurance guidelines, and an active RN license. Familiarity with utilization management systems, medical coding, and precertification software is typically required. Strong attention to detail, effective communication, and critical thinking skills help nurses advocate for patients and coordinate with providers and insurers. These skills are vital for ensuring appropriate care authorization, reducing claim denials, and supporting efficient healthcare delivery.

What is the difference between Precertification Nurse vs Utilization Review Nurse?

AspectPrecertification NurseUtilization Review Nurse
CertificationsRN license, possibly certifications in case management or healthcare qualityRN license, certifications in case management or healthcare quality
Work EnvironmentInsurance companies, healthcare providers, or third-party review organizationsInsurance companies, healthcare facilities, or third-party review organizations
Primary FocusPre-authorization of procedures and services before deliveryReview of services already provided for appropriateness and necessity

Precertification Nurses focus on obtaining approval before procedures, while Utilization Review Nurses evaluate the necessity of services after they are performed. Both roles require similar credentials and often work in the same environments, but their primary responsibilities differ in timing and purpose.

What are popular job titles related to Precertification Nurse jobs in Ohio?

For Precertification Nurse jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Precertification Nurse jobs in Ohio look for?

The top searched job categories for Precertification Nurse jobs in Ohio are:

Precertification Nurse jobs near you
Infographic showing various Precertification Nurse job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $71,394 per year, or $34.3 per hour.

ONCOLOGY - FINANCIAL NAVIGATOR LICENSED PRACTICAL NURSE (LPN), Part-time Days

Wauseon, OH • On-site

Fulton County Health Center
Health Care and Social Assistance • 501 - 1,000 employees

6.2

Company rating: 6.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

825th of 1,064 rated hospitals

Great coworkers

Good training

Learn more about Fulton County Health Centerexternal

$24.25 - $32.75/hr

Part-time

Posted 21 days ago

Job description

Description

Nursing - Oncology Financial Navigator Licensed Practical Nurse (LPN)


Department: Oncology

Status Hours: Part-time, 40 hours bi-weekly

Shift: 1st shift, 8:00 AM - 4:30 PM


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Job Summary:

Fulton County Health Center is seeking a compassionate and detail-oriented Oncology Financial Navigator Licensed Practical Nurse (LPN) to join our Oncology team. This role is essential in supporting patients, providers, and care teams throughout the oncology journey by coordinating care, verifying insurance coverage, and assisting with financial navigation. The ideal candidate will ensure patients receive timely treatment while helping remove financial and logistical barriers to care.


Key Responsibilities:

  • Provide exceptional customer service to oncology patients, physicians, provider offices, pharmacies, and insurance companies
  • Verify insurance benefits, precertification requirements, and confirm coverage for scheduled services
  • Identify coverage gaps, high deductibles, and co-pays, and pursue patient assistance options
  • Coordinate individualized patient care plans in a physician practice setting
  • Implement provider orders and evaluate nursing care for oncology patients
  • Assist patients with medication assistance programs, including financial paperwork, approvals, ordering, and delivery coordination
  • Manage "white bag" medication processes, including securing approvals, coordinating with pharmacies, and scheduling patients
  • Maintain consistent communication with insurance companies to ensure timely approvals
  • Assist patients with additional needs such as transportation, housing, and medical bill support
  • Build strong relationships with physicians and hospital staff to promote early referral of patients in need of financial navigation services

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Requirements

Licensure: Current Licensed Practical Nurse (LPN) license from the State of Ohio Board of Nursing required

Experience: Minimum of 6 months experience in a medical office or insurance-related setting required; 1 year preferred

Knowledge: Understanding of insurance verification and precertification processes, including medical documentation requirements

Preferred Skills: Experience or education related to CPT, HCPCS, and ICD-10 coding preferred

Other: Education and/or experience may be substituted for required skills (subject to manager approval)

What Fulton County Health Center employees say

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Hours and flexibility

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