Denials Prevention Specialist - Registration Quality at Western Missouri Medical Center

Warrensburg, Missouri, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Aug, 26

Salary

0.0

Posted On

21 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Integrity, Claim Denials, Root Cause Analysis, Process Improvement, Education, Collaboration, Auditing, MEDITECH, Patient Access, Billing QA, Denial Prevention, Eligibility Verification, Workflow Gaps, Training Materials, Reporting, Performance Monitoring

Industry

Hospitals and Health Care

Description

Description Position Summary The Denials Prevention Specialist – Registration Quality is responsible for identifying, correcting, and preventing registration-related errors that lead to claim denials. This role focuses on improving front-end data integrity within MEDITECH, working across Patient Access, Billing QA, and Denials teams to reduce eligibility, authorization, and demographic-related denials. This position serves as the bridge between front-end operations and downstream revenue cycle performance, ensuring that patient accounts are accurate before claims are created. --- 1. Registration Quality Review (Primary Function) · Audit patient accounts for accuracy in: o Insurance selection and plan accuracy o Member ID and group number o Demographics (name, DOB, address) o Guarantor information o Coordination of benefits (COB) · Work MEDITECH work queues: o REG-ERR-* o REG-ELIG-* o Registration-related denial queues (DEN-ELIG-*, DEN-REG-*) · Correct errors prior to claim submission when possible --- 2. Denial Root Cause Analysis (Front-End Focus) · Review denied claims to identify registration-driven root causes, including: o Eligibility failures o Incorrect payer selection o Missing or incorrect subscriber data · Categorize and track denial trends tied to registration issues · Quantify impact (volume, dollars, repeat errors) --- 3. Front-End Process Improvement · Identify workflow gaps in: o Scheduling o Registration o Eligibility verification · Recommend and help implement process improvements to reduce errors at intake · Partner with leadership to standardize front-end practices --- 4. Education & Training · Provide ongoing education to Patient Access staff on: o Common registration errors o Payer-specific requirements o Best practices for insurance capture · Develop quick-reference guides and training materials · Conduct targeted retraining for individuals or departments with high error rates --- 5. Collaboration Across Revenue Cycle · Work closely with: o Denial Specialists (to understand downstream impact) o Billing QA (to align front-end corrections with claim edits) o Coding (when registration impacts billing accuracy) · Participate in cross-functional denial prevention meetings --- 6. Work Queue & SLA Management · Maintain assigned MEDITECH work queues: o Prioritize high-risk and high-dollar accounts o Ensure timely correction of errors before billing · Meet established turnaround times (typically =24–48 hours pre-bill) --- 7. Reporting & Performance Monitoring · Track and report: o Registration-related denial rates o Error trends by registrar/location o Improvement over time · Provide actionable insights to leadership --- Work Queue Ownership · REG-ERR-* · REG-ELIG-* · DEN-ELIG-* (for root cause analysis and feedback loop) · Registration-related pre-bill edit queues

Responsibilities

The Denials Prevention Specialist is responsible for identifying and correcting registration-related errors that lead to claim denials, focusing on improving data integrity within MEDITECH. This role involves auditing patient accounts, analyzing denial trends, and collaborating with various teams to enhance front-end processes.