[Hiring] Pre-registration and Denial Prevention Specialist @Capitol Imaging Services

Role Description

The Regional Pre-Registration & Denial Prevention Specialist protects reimbursement before the patient arrives. This position works closely with outsourced vendors, technology partners, and internal CIS locations and teams to ensure:

• Insurance coverage is verified.
• Complete benefit information is obtained.
• Patient financial responsibility is communicated clearly.
• Required prior authorization is secured before the patient is scheduled and seen.

Qualifications

• Minimum of 3 years of experience in healthcare pre-registration, insurance verification, prior authorization, patient access, denial prevention, or revenue cycle operations.
• Working knowledge of commercial, Medicare, and Medicaid coverage, benefits, eligibility, authorization, and reimbursement requirements.
• Ability to analyze denial and workflow trends, identify root causes, and translate findings into practical corrective actions.
• Strong communication, organization, training, follow-up, and problem-solving skills.
• Ability to work effectively across facility teams, outsourced vendors, technology partners, and revenue cycle leadership.
• Experience with healthcare technology platforms, payer portals, eligibility tools, and electronic medical record or practice management systems.

Requirements

• Coordinate daily with outsourced vendors, technology partners, and CIS facility teams to keep pre-registration and financial clearance work accurate, timely, and complete.
• Confirm active insurance coverage and eligibility for the scheduled date of service, including the correct payer, plan, member information, network status, and coverage details.
• Obtain and document complete benefit information, including copayments, coinsurance, deductibles, remaining deductible balances, coverage limitations, and other patient responsibility.
• Ensure patient benefits and expected financial responsibility are communicated clearly to the patient before the service.
• Identify when prior authorization, precertification, referral, or other payer approval is required and ensure it is obtained and documented before the patient is scheduled and seen.
• Investigate and resolve discrepancies involving eligibility, benefits, authorization, network participation, patient estimates, and registration information.
• Monitor the quality, timeliness, and accuracy of work completed by vendors, internal teams, and automated technology tools.
• Review front-end denials and payment variance information to identify root causes related to coverage, eligibility, authorization, registration, or pre-service workflow errors.
• Track trends by facility, payer, modality, vendor, and denial reason; communicate findings and recommend specific actions to prevent recurrence.
• Provide education, feedback, and workflow guidance to facility teams and partners to promote consistent pre-registration standards and accountability.
• Perform quality audits, maintain clear documentation, and support reporting on verification, authorization, patient collections, denial prevention, and financial clearance performance.
• Partner with revenue cycle leadership and operational teams on process improvements that increase clean claims, accelerate payment, and reduce revenue leakage.

Benefits

• Fewer denials, especially those caused by inactive or incorrect coverage, eligibility errors, and missing or invalid authorization.
• Stronger time-of-service collections, improving collection of known copayments, coinsurance, deductibles, and other patient responsibility.
• Higher collection yield by increasing the percentage of allowable amounts collected through improved front-end accuracy and financial clearance.