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Precertification Jobs in Tennessee (NOW HIRING)

Ballad Health

Patient Service Representative

Greeneville, TN

$15.50 - $19.75/hr

... precertification and prepares information for audit purposes. Requirements: Required - High School diploma or equivalent; previous experience performing data entry and utilizing database. Ability to ...

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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 Tennessee? The most popular types of Precertification jobs in Tennessee are:
What are popular job titles related to Precertification jobs in Tennessee? For Precertification jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Precertification jobs in Tennessee look for? The top searched job categories for Precertification jobs in Tennessee are:
Precertification jobs near you
Infographic showing various Precertification job openings in Tennessee as of May 2026, with employment types broken down into 3% As Needed, 84% Full Time, and 13% Part Time. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.
Precertification Specialist - UT Gastroenterology

Precertification Specialist - UT Gastroenterology

University Physicians' Association

Knoxville, TN

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Job description

Description

University Physicians' Association (UPA) is seeking a detail-oriented and customer-focused Precertification Specialist to join our UT Gastroenterology team. This is a fast-paced, specialty practice located within UT Medical Center, offering the opportunity to play a key role in ensuring patients receive timely, seamless care.


Position Summary

The Precertification Specialist serves as a vital liaison between patients, providers, and insurance companies. This role is responsible for verifying insurance benefits and eligibility, obtaining necessary authorizations, preparing procedure codes and estimates, and collecting prepayments when applicable-all with a strong focus on accuracy and patient service.


Key Responsibilities
  • Monitor scheduled procedures and maintain an organized tracking list for precertification status
  • Verify insurance eligibility and benefits via phone and online portals
  • Obtain prior authorizations according to payer requirements
  • Update insurance and policy details in the NextGen system
  • Confirm receipt of all required authorization documentation prior to procedures
  • Assign appropriate ICD-10 and CPT codes
  • Communicate effectively with clinical and administrative staff to support timely procedures
  • Perform additional duties as assigned to support the practice
Why Join UPA?

UPA offers a supportive team environment along with a comprehensive benefits package, including:

  • Paid Time Off (PTO), Paid Holidays, and Sick Leave
  • Medical, Dental, and Vision Insurance
  • Short-Term and Long-Term Disability
  • Life Insurance
  • 401(k) with company match and immediate vesting
  • Critical Illness coverage and more

If you enjoy working in healthcare, thrive in a detail-driven role, and value teamwork and stability, we'd love to hear from you!

Requirements

Education, Training, and Experience

  • Professional medical coding certification or a minimum of two years of related experience preferred
  • Insurance verification experience required
Skills, Knowledge, and Abilities
  • Maintains a professional and polished appearance
  • Strong verbal communication and interpersonal skills
  • Working knowledge of medical billing practices and managed care environments
  • Familiarity with a variety of insurance plans and payer types
  • Highly organized, detail-oriented, and self-motivated
  • Proficient in Microsoft Office and Windows-based applications

Apply