Registration Denial Prevention Specialist – Methodist Health System

Title of the Job: Registration Denial Prevention Specialist

Location: Omaha, NE

Job Description: Why work for Nebraska Methodist Health System?
At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.Job Summary: Location: Methodist Corporate Office
Address: 825 S 169th St. – Omaha, NEWork Schedule: Mon – Fri, 8:00am to 4:30pm, but flexible with weekly scheduleResponsible to notify payers and secure authorizations for defined services. Monitors registration error queues and proactively audits registration encounters to identify registration error trends. Collaborates with registration leadership to educate and train on registration error trends to prevent payment denials.Responsibilities:Essential Functions1. 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).

2. 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.

3. 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.

4. 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.

Schedule:Mon – Fri, 8:00am to 4:30pm, but flexible with weekly scheduleJob Description:Job RequirementsEducation

• Associate’s degree in healthcare management or related field required.

Experience

• Minimum 2 years of preauthorization, registration or healthcare billing operations experience required.
• Clinical experience preferred.

License/Certifications

• N/A

Skills/Knowledge/Abilities

• 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.

Physical RequirementsWeight Demands

• Medium Work – Exerting up to 50 pounds of force.

Physical ActivityNot necessary for the position (0%):

• Climbing
• Crawling
• Kneeling

Occasionally Performed (1%-33%):

• Balancing
• Carrying
• Crouching
• Distinguish colors
• Grasping
• Lifting
• Pulling/Pushing
• Standing
• Stooping/bending
• Twisting
• Walking

Frequently Performed (34%-66%):

• Fingering/Touching
• Keyboarding/typing
• Reaching
• Repetitive Motions
• Sitting
• Speaking/talking

Constantly Performed (67%-100%):

• Hearing
• Seeing/Visual

Job HazardsNot Related:

• Chemical agents (Toxic, Corrosive, Flammable, Latex)
• Equipment/Machinery/Tools
• Explosives (pressurized gas)
• Electrical Shock/Static
• Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
• Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
• Mechanical moving parts/vibrations

Occasionally (34%-66%):

• Biological agents (primary airborne and blood born viruses) (Jobs with Patient contact) (BBF)
• Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)

About Methodist:Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.

Company Name: Methodist Health System

Salary:

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