Registration Denial Prevention Specialist

Nebraska Methodist Hospital•Omaha, NE

8d•Hybrid

About The Position

This role is responsible for notifying payers and securing authorizations for defined services. The specialist will monitor registration error queues and proactively audit registration encounters to identify registration error trends. They will collaborate with registration leadership to educate and train staff on these trends to prevent payment denials. This position is part of a team that makes a real difference in the communities served by Nebraska Methodist Health System.

Requirements

Associate’s degree from an accredited school in healthcare management or related field, or an equivalent combination of education and experience combined required.
Minimum 2 years of preauthorization, registration or healthcare billing operations experience required.
Skill using computers and office equipment.
Skill organizing and prioritizing work.
Skill with verbal and written communication.
Knowledge of medical terminology.
Knowledge of Health Insurance Portability and Accountability Act (HIPAA) regulations.
Ability to travel between facilities location.
Ability to identify opportunities and commit to the continuous improvement of services.
Ability to adhere to all workplace and safety requirements, regulations, standards, and practices.
Ability to work independently.
Ability to accurately perform work.

Nice To Haves

Clinical experience preferred.

Responsibilities

Complete notification of patient admission following guidelines for specified payers. Monitor daily admission reports for assigned payers/services. Complete telephonic or online preauthorization/notification as appropriate. Provide demographic and clinical information as requested to payers. Document notification/preauthorization information, including contact person, contact numbers and authorization/notification in the appropriate areas in the Electronic Medical Record (EMR).
Proactively reviews registrations to identify registration error trends that may result in payer denials. Audit registration encounters to identify registration errors. Monitor Registration Quality Assurance work queues to identify missed alerts and immediately corrects registration errors as discovered. Track and analyze registration error trends and collaborates with leadership team to educate staff regarding process improvement opportunities. Routinely attends access denial meetings. Collaborate with leadership and staff to identify educational opportunities based on denial investigations.
Serve as a resource to the registration staff and leadership to provide consistent information regarding departmental policy and procedures. Maintain teamwork, positive mentoring and assist with implementation of new procedures and job functions to enhance Registration services. Provide reinforcement training for payer changes or implementation of new payers or card updates. Travel to various locations to support on site education for staff. Provide ad hoc training for staff meetings in collaboration or at the direction with leadership.
Collect and analyze registration department compliance metrics to identify performance improvement opportunities. Routinely monitors department compliance metrics. Analyze compliance results, identifies performance improvement opportunities. Collaborate with leadership to validate findings and improve education/training plans.