Insurance Specialist

Insurance Specialist

Centerpoint - Georgetown Kentucky Bariatrics Institute is operated jointly with Lifepoint Health. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an Insurance Specialist joining our team, you're embracing our promise to provide superior patient care that exceeds industry standards as well as patient expectations. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off
• Employee Assistance Program mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants
• And much more...

An Insurance Specialist is responsible for verifying insurance eligibility and benefits, obtaining prior authorizations and referrals, tracking payer requirements, coordinating insurance approvals, and supporting patients through the process for bariatric surgery and medical weight management services. This position serves as a liaison between patients, providers, insurance companies, and referring offices to facilitate timely access to care.

• Perform insurance verification, eligibility, benefit review, and prior authorization activities for bariatric surgery and medical weight management services
• Review insurance plans to determine coverage requirements, exclusions, referrals, and medical necessity criteria
• Obtain required prior authorizations and referrals from insurance carriers
• Submit clinical documentation and supporting records to insurance companies as required
• Monitor authorization status and follows up with payers to ensure timely determinations
• Document authorization activity and insurance updates accurately within the electronic medical record
• Communicate authorization approvals, denials, and pending requirements to providers, staff, and patients
• Educate patients regarding insurance requirements, benefit coverage, and authorization processes
• Coordinate appeals and reconsideration requests for denied services when appropriate
• Maintain current knowledge of payer policies, bariatric surgery coverage criteria, and medical weight management requirements
• Communicate with insurance representatives regarding authorization requirements, documentation requests, and claim-related questions
• Work closely with providers, clinical staff, scheduling personnel, and referring offices to facilitate patient progression through the program
• Track and maintain insurance-related documentation in accordance with organizational policies
• Support workflow improvement initiatives related to insurance processing and patient access
• Assist with patient inquiries regarding insurance coverage and authorization status

Qualifications & Requirements:

• Education: High School Diploma or equivalent required
• Associate degree or healthcare-related education preferred
• Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision
• Must be able to work in a fast-paced environment and take appropriate action
• Must be able to function effectively in a multi-task setting
• Strong organizational, communication, and customer service skills
• Working knowledge of managed care plans, commercial insurance, Medicare, Medicaid, and third-party payers
• Proficient in Microsoft Office applications and electronic medical records
• One year of insurance authorization, insurance verification, medical office, revenue cycle, or related healthcare experience required
• Prior authorization experience preferred
• Bariatric surgery or surgical specialty experience preferred

Schedule: Full Time / Day

EEOC Statement

Centerpoint - Georgetown Kentucky Bariatrics Institute is an Equal Opportunity Employer Centerpoint - Georgetown Kentucky Bariatrics Institute is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.