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Precertification Jobs in Tennessee (NOW HIRING)

Phenom People

Intake Specialist PRN

Pulaski, TN · On-site

$17.50 - $23.50/hr

Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for ...

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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 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 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 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:

Infographic showing various Precertification job openings in Tennessee as of August 2026, with employment types broken down into 4% As Needed, 79% Full Time, 14% Part Time, and 3% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Business Services Spec II

Germantown, TN • On-site

Campbell Clinic
Fitness and Sports Centers • 51 - 200 employees
Learn more about Campbell Clinicexternal

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

POSITION SUMMARY
Responsible for all aspects of assigned patient accounts after charge entry to final resolution
Essential Functions Statement(s)
  • Verifies and update insurance information and demographics
  • Reviews insurance eligibility
  • Determines and reviews financial responsibilities and insurance coverage with patients
  • Resolves patient balance related questions
  • Reviews surgery costs and establishes payment plans for patient portion
  • Processes patient and payor refunds
  • Identifies accounts for referral to outside collection agency
  • Edits claim holds
  • Keeps up with changes in payor processes and reports them to coordinator for appropriate action
  • Obtains all precertification
  • Responds to correspondence from payors and patients
  • Performs other duties as assigned
SKILLS & ABILITIES
Education: High School Graduate or General Education Degree (GED)
Experience: Previous healthcare billing experience is preferred
Computer Skills: Must be computer literate. Basic computer skills required. Must be able to type.
Campbell Clinic Benefit Summary:
Campbell Clinic offers a lucrative benefit package to support employees and their families.
  • Medical / Dental / Vision Insurance
  • HRA Option
  • Flexible Spending Account
  • Basic Life Insurance
  • Voluntary Life Insurance Option
  • Long-Term Disability
  • Voluntary Short-Term Disability
  • Accident Insurance
  • Critical Illness Insurance
  • 401(k) Plan Matching + Profit Sharing
  • Employee Assistance Program
  • Paid Time Off
  • 8 Paid Holidays

Equal Opportunity Employer/Veterans/Disabled

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