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Precertification Jobs in Ohio (NOW HIRING)

Medical University of South Carolina

$16.25 - $20/hr

Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC002349 CHSCorp - Precertification Unit Pay Rate Type Hourly Pay Grade Health-20 ...

Trinityhealth

Patient Financial Specialist III

Columbus, OH · On-site

$17.50 - $23.25/hr

The Patient Financial Specialist III performs all the functions of a PFS II. In addition, the PFS III performs verification of prior authorization and obtaining precertification for selected ...

Trinity Health

Patient Financial Specialist III

Columbus, OH · On-site

$17.50 - $23.25/hr

The Patient Financial Specialist III performs all the functions of a PFS II. In addition, the PFS III performs verification of prior authorization and obtaining precertification for selected ...

Pavilion Management Company

OH · On-site

$17.50 - $23.75/hr

Timeliness of precertification initiation * Accuracy and completeness of admission documentation * Contribution to census growth and occupancy targets

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Precertification information

What are precertification jobs?

Precertification jobs involve reviewing and approving medical procedures, treatments, or hospital admissions before they occur to ensure they meet insurance or regulatory requirements. Professionals in these roles typically evaluate patient information, communicate with healthcare providers, and coordinate with insurance companies to determine if services will be covered. This process helps control healthcare costs and ensures that patients receive appropriate care according to established guidelines. Precertification specialists often work in hospitals, insurance companies, or healthcare administration settings.

What are some common challenges faced by Precertification Specialists, and how can they be addressed?

Precertification Specialists often face challenges such as staying up-to-date with constantly changing insurance guidelines, managing high volumes of requests, and communicating effectively with both healthcare providers and insurance representatives. To address these, it is important to maintain strong organizational skills, leverage available technology for tracking authorizations, and participate in ongoing training to remain current on payer requirements. Building good relationships with team members and regularly sharing updates can also help streamline processes and minimize delays.

What are the key skills and qualifications needed to thrive in a precertification specialist role, and why are they important?

Success as a precertification specialist requires knowledge of medical terminology, insurance verification, and healthcare regulations, often supported by a background in healthcare administration or certification such as Certified Medical Administrative Assistant (CMAA). Familiarity with insurance portals, electronic health record (EHR) systems, and payer-specific software is typically necessary. Attention to detail, strong organizational skills, and effective communication are vital soft skills that help in coordinating between providers, patients, and insurers. These abilities ensure accurate and timely approval of medical procedures, reducing delays in patient care and minimizing claim denials.

What is the difference between Precertification vs Medical Coder?

AspectPrecertificationMedical Coder
Required credentialsCertification may be preferred; knowledge of insurance policiesCertification (e.g., CPC, CCS) often required
Work environmentHealthcare facilities, insurance companies, outpatient clinicsHospitals, clinics, insurance companies, remote work
Employer usageUsed to approve procedures before serviceUsed to assign codes for billing and documentation
Common search intentPrecertification vs Medical Coder

Precertification involves obtaining approval from insurance companies before procedures, focusing on insurance policies and patient eligibility. Medical coders assign standardized codes to medical records for billing, emphasizing coding accuracy and documentation. While both roles are integral to healthcare billing, precertification is about approval processes, whereas medical coding centers on documentation and coding accuracy.

What are the most commonly searched types of Precertification jobs in Ohio? The most popular types of Precertification jobs in Ohio are:
What are popular job titles related to Precertification jobs in Ohio? For Precertification jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Precertification jobs in Ohio look for? The top searched job categories for Precertification jobs in Ohio are:
Precertification jobs near you
Infographic showing various Precertification job openings in Ohio as of July 2026, with employment types broken down into 3% As Needed, 82% Full Time, and 15% Part Time. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.
Lead Precertification Specialist

Lead Precertification Specialist

Medical University of South Carolina

On-site

$16.25 - $20/hr

Full-time

Re-posted 5 days ago

Job description

Job Description Summary

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC002349 CHSCorp - Precertification Unit

Pay Rate Type

Hourly

Pay Grade

Health-20

Scheduled Weekly Hours

40

Work Shift

Job Description

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

Additional Job Description

Education: High School Degree or Equivalent Work Experience: 1 year

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

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