Pre-registration and Denial Prevention Specialist (51155)

Regional Pre-Registration & Denial Prevention Specialist

LOCATION
Remote, with travel as needed

DEPARTMENT
Revenue Cycle Management

About Capitol Imaging Services

Capitol Imaging Services (CIS) is a fast-growing outpatient diagnostic imaging provider with 60 centers across six states in the Gulf Coast and Southeastern United States and GROWING. CIS provides advanced imaging services including PET/CT, MRI, CT, mammography, ultrasound, X-ray, and more, with a strong commitment to accessible, high-quality care and an excellent patient experience. As CIS continues to grow, we are looking for talented denial-prevention and patient-experience professionals who want to help patients navigate their care with confidence and help our teams deliver consistent service across every location. CIS is proud to be a team-oriented workplace that employees recommend to friends and family. Come grow with us and help shape the future of outpatient imaging.

Position Purpose

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 make sure insurance coverage is verified, complete benefit information is obtained, patient financial responsibility is communicated clearly, and required prior authorization is secured before the patient is scheduled and seen.

PRIMARY OBJECTIVE
Complete accurate financial clearance before service so preventable denials and revenue leakage are reduced, patient collections improve, and allowable reimbursement is collected faster and more completely.

Key Outcomes

1 FEWER DENIALS

Reduce preventable denials, especially those caused by inactive or incorrect coverage, eligibility errors, and missing or invalid authorization.

2 STRONGER TIME-OF-SERVICE COLLECTIONS

Improve collection of known copayments, coinsurance, deductibles, and other patient responsibility at or before the time of service.

3 HIGHER COLLECTION YIELD

Increase the percentage of allowable amounts collected by improving front-end accuracy, financial clearance, and follow-through.

Business impact: These outcomes support improved DSO, faster time to payment, stronger cash flow and earnings, and less revenue leakage.

Key Responsibilities

- 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, supporting informed decisions and time-of-service collections.

- 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 before they affect care or reimbursement.

- Monitor the quality, timeliness, and accuracy of work completed by vendors, internal teams, and automated technology tools; escalate gaps and drive corrective action.

- 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.

Performance Focus

- Coverage, eligibility, and authorization denial rates and trends

- Accuracy and timeliness of insurance verification, benefit capture, and authorization completion

- Patient financial responsibility communicated before service

- Time-of-service patient collections

- Collection yield on allowable amounts

- Days sales outstanding (DSO), time to payment, and revenue leakage indicators

- Vendor, technology, and facility adherence to pre-registration standards

Required 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.

Preferred Experience

- Outpatient imaging or radiology pre-registration, authorization, benefit, or patient estimate experience.

- Front-end denial management and denial prevention experience.

- Experience monitoring vendor or automation performance.

- Strong analytical and reporting skills.

What Success Looks Like

- Patients are financially cleared with accurate coverage, benefits, and required authorization before service.

- Patients understand their expected responsibility and are better prepared to pay at or before the time of service.

- Coverage, eligibility, and authorization denials decline because issues are identified and corrected upstream.

- CIS locations, vendors, and technology partners follow consistent standards and resolve performance gaps quickly.

- More of the allowable reimbursement is collected, cash arrives sooner, and avoidable revenue leakage is reduced.