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Precertification information

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$5

$18

$30

How much do precertification jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for precertification in the United States is $18.93, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $27.40 per hour, depending on experience, location, and employer.

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.

More about Precertification jobs
What cities are hiring for Precertification jobs? Cities with the most Precertification job openings:
What are the most commonly searched types of Precertification jobs? The most popular types of Precertification jobs are:
What states have the most Precertification jobs? States with the most job openings for Precertification jobs include:
What job categories do people searching Precertification jobs look for? The top searched job categories for Precertification jobs are:
Precertification jobs near you
Infographic showing various Precertification job openings in the United States as of July 2026, with employment types broken down into 4% As Needed, 84% Full Time, and 12% Part Time. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $39,368 per year, or $18.9 per hour.

Precertification Specialist - Surgery

Princeton Brain Spine and Orthopedics

Newtown, PA • On-site

Full-time

Posted 22 days ago

Job description

Surgical Precertification Specialist
Full-Time - Remote
MUST LIVE IN NJ, PA OR FL
Position Summary
This role handles the end-to-end authorization process for commercial insurance carriers to make sure surgical cases get approved correctly, cleanly, and on time. The specialist works closely with surgeons, schedulers, patients, and insurance reps to keep cases moving and prevent last-minute surprises.
Key Responsibilities
• Review surgery requests for accuracy, completeness, and medical necessity documentation
• Submit prior authorization requests to payers; track and follow up until determination
• Communicate case status to surgeons, schedulers, clinical staff, and patients
• Verify benefits insurance is active to obtain authorization
• Request and collect clinical records, imaging reports, and supporting documentation
• Handle peer-to-peer requests, denials, and appeals coordination
• Maintain organized case logs and meet turnaround time expectations
• Identify payer quirks, trends, and requirements to prevent delays
  • Maintain flexibility within the role to deliver the best possible patient care
    • Work collaboratively with the rest of the precertification team to keep workflows tight and predictable
    • Provide excellent customer service

Qualifications
• MUST live in NJ, PA or FL
  • MUST HAVE Experience with precertification or prior authorization for surgical services
    • Neuro/Spine/Ortho/Pain Management surgery experience preferred but not required
    • Strong understanding of medical terminology, CPT/ICD-10 codes, and clinical documentation
    • Comfort working with EMRs, payer portals, Microsoft and Adobe
    • Solid communication skills - clear, direct, and calm
    • Ability to juggle multiple cases without losing track
    • Detail-oriented with good judgement on what needs escalation and what just needs another phone call
    • High level of reliability and follow-through

Apply