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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 ...

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 ...

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Precertification information

What is a precertification specialist?

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 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 skills and qualifications are needed to thrive as a precertification specialist?

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, 79% Full Time, 16% Part Time, and 2% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution.

Surgical Services Precertification Specialist

Bridgeview Eye Partners

Cuyahoga Falls, OH • On-site

Part-time

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago

Job description

Surgical Services Precertification Specialist
Join Our Team!
At Davis Eye Center, our mission is to improve the lives of our patients through exceptional vision care. We're looking for a detail-oriented, organized, and patient-focused Surgical Services Precertification Specialist to join our growing team. In this role, you'll play a vital part in ensuring our patients receive timely surgical care by securing insurance authorizations and coordinating with providers, payers, and internal teams.
If you enjoy working behind the scenes to support outstanding patient care while collaborating with a dedicated surgical services team, we'd love to hear from you.
WHAT WE OFFER:
  • 6.5 paid holidays per year
  • PTO after the first 60 days of employment
  • Full slate of benefits to include health, dental, vision, and 401k
  • Growth and wage increase through company paid certification program

What You'll Do
  • Obtain insurance prior authorizations and precertifications for surgical procedures.
  • Verify insurance benefits, eligibility, and coverage requirements.
  • Review clinical documentation to ensure authorization requirements are met.
  • Communicate with insurance carriers regarding authorization status and appeals.
  • Coordinate with surgeons, surgery schedulers, clinics, and patients to ensure all required approvals are obtained prior to surgery.
  • Maintain accurate documentation within the electronic medical record and other systems.
  • Monitor authorization expiration dates and manage renewals when necessary.
  • Resolve authorization denials and assist with appeals as appropriate.
  • Stay current on payer guidelines, authorization requirements, and regulatory changes.
  • Provide exceptional customer service while maintaining patient confidentiality and HIPAA compliance.

What We're Looking For
  • High school diploma or equivalent required; associate degree preferred.
  • Previous experience with insurance verification, prior authorizations, medical billing, or healthcare administration preferred.
  • Knowledge of medical terminology, CPT, ICD-10, and insurance processes preferred.
  • Strong attention to detail and excellent organizational skills.
  • Ability to prioritize multiple tasks in a fast-paced environment.
  • Excellent verbal and written communication skills.
  • Proficiency with electronic medical records and Microsoft Office applications.
  • Ability to work independently while collaborating effectively with cross-functional teams.

PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA guidelines):
  • Physical Activity: Standing, Walking, Stooping, Grasping, Typing, and Manual dexterity. The worker is required to have visual and verbal acuity to determine the accuracy, neatness, and thoroughness of the work assigned.
  • Physical Requirements: Must be able to lift up to 15 pounds on a regular basis from floor to waist, 5 pounds from waist to shoulder, and 5 pounds from shoulder to overhead.
  • Work Environment: Professional medical office environment.

Make an Impact
Every successful surgery begins long before the patient enters the operating room. As a Surgical Services Precertification Specialist, you'll help ensure our patients receive seamless, timely care while supporting our physicians and surgical teams every step of the way.
Apply today and help us bring exceptional vision care to every patient we serve.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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