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Precertification Jobs (NOW HIRING)

Mercyhealth

Precertification Specialist

Lake Geneva, WI · On-site

$17.57 - $26.36/hr

Identify all relevant patient data elements and information from the various systems to acquire precertification. * Contacts insurance companies or employer groups to obtain pre-certifications ...

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How much do precertification jobs pay per hour?

As of Jun 7, 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 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, with an average salary of $39,368 per year, or $18.9 per hour.

PRECERTIFICATION PRIOR AUTHORIZATION SPECIALIST, WOMEN'S HEA

SGMC Health

Valdosta, GA • On-site

Full-time

Medical, Life, Retirement, PTO

Posted 19 days ago

Job description

Description
WHAT IT'S LIKE AT SGMC HEALTH
Purpose. No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place.
Excellence. We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service.
Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment.
Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides.
WHY YOU WILL LOVE SGMC HEALTH
SGMC Health has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities to expand your skill set. Some of these great benefit options are listed below:
  • Low Healthcare Insurance Premiums
  • 401(k) with employer match
  • Paid Time Off (PTO)
  • Employee discounts
  • Company paid life insurance
  • Short-Term and Long-Term Disability
  • Cancer Insurance
  • Accident Insurance
  • Pet Insurance
  • Tuition Reimbursement
  • On-the-job training and skills development
  • Opportunities for growth and advancement
  • Employee Assistance Program

JOB LOCATION : Women's Health
DEPARTMENT: SPN - WOMEN'S HEALTH
SCHEDULE: Full Time, 8 HR Day Shift, 8-5 M-Th; 8-12 Fri
POSITION SUMMARY
Responsible for obtaining precertification and/or prior authorization for each patient for which testing and/or procedures have been ordered by the Surgeon, prior to services being rendered, using appropriate diagnoses and procedure codes. The precertification and/or authorization must be obtained on each patient; preferably prior to their scheduled appointment. If not able to obtain precertification and/or authorization, specialist must contact the patient to reschedule their appointment. Responsible for reviewing for accuracy of information requested and received in regard to precertification and/or prior authorization numbers received, as well as supporting documents. Responsible for uploading into SGMC Health EHR software system, authorization numbers, time spans/number of procedures, etc. and supporting documentation upon verification that procedures are authorized as requested. Responsible for monitoring and tracking of authorization requests and expiring authorizations. Responsible for the use of and, documentation in, SGMC Health EHR software system as the official medical record, following appropriate guidelines for documenting. Responsible for contributing to department development. Perform front office reception and various customer service duties. Other duties as identified and assigned by Practice Manager.
KNOWLEDGE, SKILLS & ABILITIES
  • High school graduate preferred.
  • Minimum (1) year prior administrative experience or equivalent; preferable in a hospital or medical office setting to include working knowledge of insurance and managed care.
  • Must have excellent computer (technical and systems) skills & knowledge: PC and Windows literacy required, as well as Microsoft Office applications - Outlook, Word, Excel, etc. as well as a variety of other office machines. Prior use of medical office software database preferred.
  • Must possess excellent communication and interpersonal skills, and must be able work effectively as part of a team and respond well to supervision.
  • Self-motivated, showing initiative to tackle important issues, problems and tasks.
  • Attention to detail skills are critical; ability to manage multiple tasks, meet deadlines and be flexible in order to adapt to variety on the job; ability to cross train to other functions as necessary.
  • Requires flexibility in work scheduled for accountability expectations for operations and process management in a customer focused business.
WORKING CONDITIONS - ADA INFORMATION
Generally regular work schedule during normal office hours. Comfortable setting indoors. May be subjected to high levels of stress. Must be able to sit for prolonged periods of time. Moderate heavy lifting (0-25 lbs.), reaching, stooping, pushing, pulling, bending and twisting. Must be able to operate office equipment to include FAX, copier, and computer.
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