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WWAYPOINT
Lifepoint Health·Georgetown, KY

Insurance Specialist

Full timeDays
✓Requirements
Education
✓High School Diploma or equivalent required
✓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
Associate degree or healthcare-related education preferred
Qualifications
✓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 servic
✓This position serves as a liaison between patients, providers, insurance companies, and referring offices to facilitate timely access to care.
✓How you’ll contribute
✓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
Prior authorization experience preferred
Bariatric surgery or surgical specialty experience preferred
+Benefits
✓Medical, dental and vision
✓401(k)
✓Paid time off
✓Tuition assistance
✓Wellness and mental health resources
Pay for this position
Pay not listed
Apply to Lifepoint Health ↗
Questions about pay or the unit? Ask a Waypoint recruiter.
✓You’ll need
Education
✓High School Diploma or equivalent required
✓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
Associate degree or healthcare-related education preferred
Qualifications
✓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 servic
✓This position serves as a liaison between patients, providers, insurance companies, and referring offices to facilitate timely access to care.
✓How you’ll contribute
✓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
Prior authorization experience preferred
Bariatric surgery or surgical specialty experience preferred
+Benefits
Medical, dental and vision401(k)Paid time offTuition assistance
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About the role

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.