Insurance Front Loader

Community Health Center of Fort Dodge, Inc•Fort Dodge, IA

10h•$18 - $24•Onsite

About The Position

The Front Loader/Insurance Verifier is responsible for proactively preparing patient records and verifying insurance information prior to scheduled appointments to support an efficient, accurate, and positive patient experience. This position serves as an important component of the revenue cycle and patient access process by ensuring patient demographics, insurance eligibility, coverage information, required documentation, and other registration information are complete and accurate before the patient presents for care. The Front Loader/Insurance Verifier reviews upcoming schedules in advance, identifies missing or inaccurate information, verifies insurance coverage and eligibility, updates patient records, and communicates identified issues to appropriate staff. The position works closely with front desk staff, clinical teams, Financial Advocates, Patient Navigators, billing staff, and leadership to reduce registration errors, prevent avoidable claim denials, improve patient flow, and minimize delays at check-in. The successful candidate must demonstrate strong attention to detail, productivity, organization, communication skills, and the ability to independently identify and resolve issues before they impact the patient's appointment.

Requirements

High school diploma or GED.
Strong computer and data-entry skills.
Strong attention to detail and organizational skills.
Ability to manage multiple priorities and work independently.
Effective written and verbal communication skills.
Ability to maintain confidentiality and appropriately handle protected health information.
Exceptional attention to detail and accuracy.
Ability to identify inconsistencies and independently investigate potential errors.
Ability to work ahead and anticipate problems before they affect patient care or workflow.
Understanding of basic health insurance terminology, including deductible, copayment, coinsurance, subscriber, coordination of benefits, eligibility, authorization, and referral.
Ability to navigate multiple insurance websites and electronic systems.
Strong computer skills and ability to learn new technology.
Ability to organize and prioritize a high-volume workload.
Ability to meet established deadlines and productivity expectations.
Professional telephone and customer service skills.
Ability to communicate potentially complicated insurance information in understandable terms.
Ability to work effectively with patients from diverse socioeconomic and cultural backgrounds.
Ability to work independently while functioning effectively as part of a multidisciplinary team.
Problem-solving skills and willingness to escalate concerns when appropriate.
Ability to sit and work at a computer for extended periods.
Ability to communicate effectively by telephone, electronically, and in person.
Ability to perform repetitive keyboarding and data-entry activities.
Ability to occasionally move throughout the clinic as required to perform job responsibilities.
Support the organization's mission and demonstrate a commitment to providing accessible, high-quality, patient-centered healthcare.
Treat patients and coworkers with dignity and respect, work collaboratively across departments and locations, maintain accountability for assigned responsibilities, and contribute positively to the organization's culture.
Approach the position with a proactive mindset.

Nice To Haves

One or more years of experience in healthcare registration, patient access, medical billing, insurance verification, scheduling, or a related healthcare setting.
Experience working with Medicaid, Medicare, Medicare Advantage, and commercial insurance.
Experience working in a Federally Qualified Health Center (FQHC), medical clinic, dental clinic, behavioral health clinic, hospital, or other healthcare organization.
Experience using Epic or another electronic health record system.
Knowledge of medical and/or dental insurance terminology and revenue cycle processes.

Responsibilities

Review upcoming provider schedules in advance of patient appointments according to established organizational timelines.
Prepare patient records so registration and clinical staff have accurate and complete information available prior to the patient's arrival.
Review patient demographic information for completeness and accuracy, including address, telephone number, email address, preferred language, emergency contact, and other required registration fields.
Identify missing demographic, insurance, consent, or registration information requiring follow-up.
Review patient charts for required documents, forms, and information needed for the upcoming visit.
Identify discrepancies or incomplete information and take appropriate action to correct the information or communicate the issue to the appropriate staff member.
Document completed pre-loading activities according to established workflows.
Work assigned schedules systematically to ensure all patients are reviewed within established timeframes.
Verify insurance eligibility for scheduled patients prior to their appointments using electronic eligibility systems, payer portals, Epic functionality, or other approved resources.
Confirm that insurance coverage is active for the scheduled date of service.
Verify and update: Insurance carrier and plan, Member identification number, Group number, Effective dates, Subscriber information, Patient relationship to subscriber, Primary and secondary insurance, Coordination of benefits information, Copayment, deductible, and coinsurance information when available, Primary care provider assignment when applicable.
Ensure insurance information is entered accurately into the electronic health record.
Obtain or verify electronic or scanned copies of current insurance cards when required.
Identify terminated, inactive, or changed insurance coverage prior to the patient's appointment.
Identify insurance plans for which the organization or provider may be out-of-network and escalate according to established procedures.
Identify potential coordination-of-benefits issues and communicate with the patient or appropriate staff when clarification is required.
Document insurance verification activities clearly and accurately.
Verify Medicaid eligibility and managed care organization enrollment as applicable.
Confirm the patient is assigned to the appropriate health plan and/or primary care provider when required.
Identify changes in Medicaid eligibility or managed care enrollment.
Identify coverage limitations or other payer requirements that could affect the scheduled service.
Communicate coverage concerns to appropriate staff before the patient's appointment whenever possible.
Verify Medicare eligibility and coverage information.
Confirm Medicare Advantage coverage when applicable and ensure the correct plan is listed as the patient's insurance.
Identify potential discrepancies between traditional Medicare and Medicare Advantage coverage.
Verify secondary or supplemental coverage when available.
Follow established procedures for Medicare-related documentation and registration requirements.
Review scheduled services to identify appointments or procedures that may require prior authorization, referral, or other payer approval.
Verify whether required authorization or referral information is present in the patient record.
Notify the appropriate clinical, referral, authorization, or billing staff when required documentation or authorization is missing.
Follow established workflows for escalating unresolved authorization concerns prior to the scheduled appointment.
Identify uninsured and underinsured patients who may benefit from the organization's Sliding Fee Discount Program or other financial assistance resources.
Identify patients whose Sliding Fee Discount Program documentation is expired or approaching expiration according to established procedures.
Refer patients to the appropriate Financial Advocate or designated staff member for assistance.
Ensure financial assistance needs are communicated before the appointment whenever possible to minimize delays at check-in.
Maintain separation between insurance verification responsibilities and financial eligibility determinations when required by organizational policy.
Contact patients when necessary to obtain missing insurance, demographic, or registration information prior to their appointment.
Communicate professionally and respectfully with patients regarding insurance coverage or information needed for their upcoming visit.
Explain what documentation patients should bring to their appointment when necessary.
Refer complex insurance, billing, financial assistance, or coverage questions to the appropriate staff member.
Document patient communication according to organizational standards.
Communicate unresolved issues to front desk staff prior to the patient's arrival.
Clearly identify information that must be collected or verified during check-in.
Assist front desk staff with insurance eligibility or registration questions as needed.
Support patient access operations during periods of high volume or staffing shortages as assigned.
Assist with registration, scheduling, check-in, check-out, telephone coverage, or other patient access responsibilities when operationally necessary.
Promote efficient patient flow by resolving as many registration and insurance issues as possible before the patient arrives.
Help reduce preventable claim denials caused by inaccurate demographics, inactive insurance, incorrect payer information, missing subscriber information, or other registration errors.
Correct identified registration and insurance errors promptly.
Respond to requests from billing or revenue cycle staff regarding insurance or registration discrepancies.
Identify recurring registration or insurance issues and communicate trends to leadership.
Participate in process improvement efforts designed to improve clean claim rates and reduce avoidable denials.
Follow payer-specific registration requirements and organizational revenue cycle procedures.
Meet established productivity expectations for schedules and patient records reviewed.
Maintain a high level of accuracy when entering or updating patient information.
Complete assigned pre-loading work within established timeframes.
Monitor assigned work queues and reports and resolve outstanding items promptly.
Participate in audits of insurance verification and registration accuracy.
Correct identified errors and participate in additional training when necessary.
Identify workflow barriers and recommend opportunities for improvement.
Work collaboratively with front desk staff, clinical staff, providers, Financial Advocates, Patient Navigators, referral staff, billing staff, and leadership.
Communicate concerns promptly rather than allowing unresolved issues to carry forward to the date of service.
Maintain professional and respectful communication with coworkers, patients, insurance companies, and outside organizations.
Support a team-based approach and assist coworkers when operational needs require.
Accept feedback and demonstrate a willingness to learn and adapt to changing workflows.
Participate in staff meetings, training, huddles, and process-improvement activities as assigned.
Maintain patient confidentiality and comply with HIPAA and organizational privacy and security requirements.
Access patient information only as necessary to perform assigned job responsibilities.
Follow organizational policies related to patient registration, insurance verification, financial assistance, documentation, and information security.
Complete required compliance, safety, and organizational training.
Report suspected privacy, compliance, fraud, waste, abuse, or security concerns according to organizational policy.
Maintain accurate and truthful documentation of all work performed.