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Reg Denial Prevention Spec

Methodist Health System locationOmaha, NE
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596 positions
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Web Mktg Technology Specialist

Methodist Health System locationOmaha, NE
596 positions
info linkReport a probelm Originally Posted : July 22, 2021 | Expires : September 20, 2021

Details

Salary
Unspecified
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Job Location
Omaha, NE, United States

Description

  • Purpose of Job
    • Responsible 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.
  • Job Requirements
    • Education
      • 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 Requirements
    • Weight Demands
      • Medium Work - Exerting up to 50 pounds of force.

    • Physical Activity
      • Not 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 Hazards
      • Not 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 air born and blood born viruses) (Jobs with Patient contact) (BBF)
        • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
  • Essential Job Functions
    • Essential Functions I

      • 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.

    • Essential Functions II

      • Participates in mandatory in-services and/or CE programs as mandated by policies and procedures/external agencies and as directed by management.

      • Follows and understands the mission, vision, core values, Employee Standards of Behavior and company policies/procedures.

      • Other duties as assigned.








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Methodist Health System

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