Denials Prevention Specialist - Registration Quality in Warrensburg, Missouri at Western Missouri Medical Center

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.

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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

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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)

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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

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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

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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

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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)

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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

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Work Queue Ownership

· REG-ERR-*

· REG-ELIG-*

· DEN-ELIG-* (for root cause analysis and feedback loop)

· Registration-related pre-bill edit queues