Precertification Coordinator - Family Medicine Center - Physician Practice

Position Details

Requisition #

Shift: Day

Status:
Full Time with Benefits

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better — advancing our mission to transform healthcare and serve as a leader of positive change.

The Precertification Coordinator provides essential support to the clinical office staff, physicians, and patients by efficiently coordinating all aspects of the insurance pre‑certification and referral process. This role acts as a key liaison between the practice, patients, and insurance companies to ensure timely authorization for medical services.

• Identifies, prioritizes, and processes all physician‑ordered procedures, tests, and referrals requiring pre‑certification, based on the urgency and date of the upcoming appointment.
• Utilizes online portals and direct phone contact with insurance companies to submit required clinical information and obtain authorizations in a timely manner.
• Documents all authorization and referral details, including approval numbers and status, accurately and promptly within the EMR and appropriate billing systems.
• Maintains a detailed tracking log or spreadsheet of all initiated requests, including submission dates, status updates, reasons for any delays, and final approval dates.
• Coordinates with internal staff and external departments to schedule patient appointments for tests, procedures, therapies, and evaluations as required.
• Serves as a point of contact for patient inquiries, answering incoming calls, screening and routing calls appropriately, monitoring voicemail, and relaying messages to ensure clear and continuous communication.
• Performs patient support functions as needed, which may include assisting with registration, updating demographic and insurance information, and confirming appointments.
• Maintains up‑to‑date knowledge of the various pre‑certification requirements for participating insurance and managed care plans.
• Other duties and/or projects as assigned.
• Adheres to HMH organizational competencies and standards of behavior.

• High School diploma, GED, or equivalent.
• Minimum 2–4 years of experience in a physician practice or ambulatory healthcare setting. Direct experience with insurance authorization, verification, and referral processes is required.
• Strong organizational skills with the ability to effectively prioritize and manage multiple tasks.
• Excellent communication, written, and interpersonal skills.
• Proficiency with Microsoft Office Suite (Word, Excel).
• Experience with Electronic Medical Records (EMR) systems.
• Familiarity with standard office equipment (e.g., telephones, fax machines, copiers).
• Ability to work collaboratively as part of a patient‑centered team.

• Familiarity with specific insurance carrier portals and systems (e.g., Envoy).

Minimum rate of $20.32 hourly. HMH is committed to pay equity and transparency for our team members. The posted rate of pay is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market‑competitive total rewards package.

The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate.

The base compensation determined at the time of the offer may differ from the posted rate of pay based on a number of non‑discriminatory factors, including but not limited to Labor Market Data, Experience, Education and Certifications, Skills, Geographic Location, Internal Equity, and…