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Precertification Jobs in Tennessee (NOW HIRING)

Covenant Health

RN UTILIZATION MGMT I

Knoxville, TN

Reviews precertification requests for medical necessity for all payors as applicable, referring to the second level physician reviewer those that require additional expertise. * Maintains accurate ...

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Covenant Health

RN UTILIZATION MGMT I

Knoxville, TN · On-site

Reviews precertification requests for medical necessity for all payors as applicable, referring to the second level physician reviewer those that require additional expertise. * Maintains accurate ...

Sport Ortho Urgent Care

MEDICAL ASSISTANT

White House, TN · On-site

$17 - $22/hr

Obtain precertification for outpatient testing as needed * Process referrals and schedule follow-up appointments * Answer telephones in a professional and courteous manner * Maintain well-stocked ...

Lifepoint Health

Patient Access Representative

Gallatin, TN · On-site

$16.25 - $20.75/hr

Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments (e.g., co-pays, deductibles) or refers to financial counseling as ...

LifePoint Health

Patient Access Representative

Hartsville, TN · On-site

$17.50 - $22.25/hr

Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments (e.g., co-pays, deductibles) or refers to financial counseling as ...

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All JobsPrecertification JobsPrecertification Jobs in Tennessee

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 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 August 2026, with employment types broken down into 3% As Needed, 83% Full Time, 13% Part Time, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

Patient Service Representative (730a-5p) - Kingsport, TN

Ballad Health

Kingsport, TN • On-site

$16.75 - $21.25/hr

Other

Re-posted 10 days ago

Ballad Health rating

6.5

Company rating: 6.5 out of 10

Based on 228 frontline employees who took The Breakroom Quiz

605th of 887 rated healthcare providers

Job description

Patient Service Representative (730a-5p) - Kingsport, TN

Indian Path Community Hospital | Clerical Support | Full Time

Description

Job Description: Summary: The Patient Service Representative (PSR) greets all patients and visitors in a courteous and friendly manner and registers the patient according to Ballad Health processes. The duties of the PSR may include, but are not limited to: updating and scheduling patient appointments, retrieving daily patient data for appointments and phone calls, maintaining provider(s) schedules, filing charts/medical records, copying charts/forms, pulling charts, purging charts, producing documents for providers to sign, collecting co-pays, performing data entry of office visit charges, performing collections of unpaid balances, coding encounter forms with proper payment distribution CPT & ICD-10 codes, filing and refiling insurance claims, reconciling the charge sheet, counting the cash drawer, preparing bank deposits, balancing credit cards, reviewing and correcting errors on the missing ticket report, performs closing procedures to ensure proper account balance, perform referral and precertification and prepares information for audit purposes.

Requirements: Required – High School diploma or equivalent; previous experience performing data entry and utilizing database. Ability to maintain patient confidentiality/HIPAA. Ability to communicate respectfully/kindly with patients, office staff, nurses, and medical staff Preferred – Knowledge of CPT and ICD-9 codes/billing. Previous experience utilizing Electronic Health Record (EHR) system.

Work Requirements: Shift: Day (M-F) On Call: No No Travel Required: Local Travel Shift Details: 730a-5p City/State: Kingsport, TN

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About Ballad Health

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Become a part of the Ballad Health story. Together, we are transforming our region. We're making communities healthier. We're expanding access to critical services in rural areas.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Johnson City, TN, US

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