Pre-Certification Surgery Specialist; Remote

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Pre-Certification Surgery Specialist (Remote)

Pre-Certification Surgery Specialist (Remote)
Fully Remote

Location: Remote (in the following states:
Colorado, Georgia, Illinois, Maine, Maryland, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas).

Job Type: Full-Time

Bridge the Gap Between Care and Coverage.

Behind every successful surgery is a meticulous specialist who ensures everything is cleared and ready to go. As our Pre-Certification Surgery Specialist
, you’ll be the critical link securing surgical authorizations, coordinating medical records, and keeping care on track for our patients. If you thrive in a fast-paced environment, love solving insurance puzzles, and bring a strong sense of urgency to your work, this could be the role for you.

• Collaborate with leading orthopaedic specialists in a streamlined, patient-centered setting.
• Ensure patients get the surgical care they need without financial or administrative delays.
• Enjoy comprehensive healthcare coverage, paid time off, and 401(k) options.

• Secure timely pre-certifications and pre-determinations for upcoming surgical procedures.
• Request and compile clinical treatment records needed for pre-service insurance reviews.
• Partner with insurance carriers and clinical staff to maintain smooth operations.
• Efficiently navigate electronic medical record systems while adhering to HIPAA standards.

• Minimum of 2 years of surgical pre-certification experience required (orthopaedics preferred).
• Familiarity with health insurance guidelines, Worker’s Comp, Motor Vehicle Accidents (MVA), and medical terminology.
• Exceptional attention to detail, a strong sense of urgency, and the ability to multitask in a high-volume environment.
• Proficiency in electronic medical records (EMR) software and professional communication skills across all channels.

OrthoNJ, LLC is required by New Jersey law to disclose the compensation range for this position. The hiring range for this role is $20.00-$28.00 per hour. Compensation is determined based on several factors, including but not limited to the candidate’s qualifications, relevant experience, and geographic location. Eligible full-time employees are offered a comprehensive benefits package, which may include paid time off, medical, dental, vision, and a retirement plan.

Princeton Orthopaedic Associates (POA), a division of OrthoNJ, is a Community of Extraordinary Care professionals serving Central New Jersey since 1974. With 30 physicians, including 20 Orthopaedic surgeons, across 7 office locations, urgent care centers, and surgical center, POA operates as an outcome-focused orthopaedic practice that combines extraordinary talent, advanced techniques, and cutting-edge tools with compassionate service. As part of New Jersey's largest independent orthopaedic group practice, POA physicians work collaboratively to provide personalized, patient-centered care while maintaining the values and autonomy of the private practice model.

Princeton Orthopaedic Associates is built on a foundation of compassion, patient focus, quality, collaboration, honesty, and excellence. We are a community where every team member—regardless of role—is expected to embody these values in their daily work, hold themselves and colleagues accountable to high standards, and speak up when behavior falls short of our expectations. We foster a culture of continuous improvement where feedback is welcomed, mistakes become learning opportunities, and successes are celebrated together.

As a member of our team, you'll be expected to contribute ideas, mentor new colleagues, and actively participate in…