Pre-Service Representative

St. Mary’s Healthcare has been providing high-quality, compassionate healthcare to the people of Montgomery and Fulton counties since 1903. At St. Mary’s Hospital, the Rao Outpatient Pavilion and other locations, the local, independent healthcare organization offers the comprehensive, critical services its community needs and deserves. St. Mary’s Healthcare has also been named a 2025 Times Union Top Workplace—the first acute care hospital in the Capital Region to earn the distinction since the Times Union launched the recognition program 14 years ago.

Job Requisition: PRESE001611
Employment Type: Full-Time
Shift: Days
Hours Per Week: 40-hour week

Hiring Range: $18.74 - $25.07

The actual compensation for this position will be determined based on experience and other factors permitted by law.

Responsibilities:

• Answers incoming calls: assesses callers’ needs and directs to appropriate unit.
• Schedule various diagnostic patient procedures based on the referral received from the provider’s office or the referral the patient has presented. Schedules requested exams to maximize equipment utilization by time and location, review open slots and manage waitlist within Expanse.
• Communicates prep instructions and financial clearance to the patients, as required.
• Communicates successfully with Medical Imaging staff, surgical scheduler, doctor’s offices and other providers as needed.
• Communicates changes in the patient schedule, STATS, nurse requirements, add-ons to appropriate parties.
• Opens faxes from scheduling fax servicer sent in by referring providers and renames with standard nomenclature.
• Pre-register patient accounts in EMR by verifying demographic information and ensure insurance eligibility with the patient on the phone.
• Understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services.
• Use eligibility application and authorization portals to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered.
• Documents all payer communication and pre-service patient financial conversations, including payer decisions, collection attempts and payment plan arrangements.  Responsible to meet productivity and quality metrics as established by department leadership.
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
• Follows all current policies/procedures and legal requirements pertaining to Personal Health Information (PHI) and HIPAA. Maintains patient confidentiality

Minimum Qualifications:

Education:

• High school diploma/GED required. Minimum of two (2) years of experience in Hospital or Physician office setting working in a patient access position or call center environment required (or equivalent).
• Strong insurance knowledge specific to complex scheduling needs and authorization management required. Medical terminology preferred but not required.

Certifications / Licensure: Certified Patient Financial Specialist – HBI within six (6) months from date of hire

• Must be able to speak, read, write and follow instructions in English.

Work Experience:

• 6 months computer experience required.

• Familiarity with medical terminology preferred.

Required Skills and Attributes:

• Ability to organize and establish day-to-day priorities while using critical thinking skills in all aspects of the job.
• Must be able to multitask while remaining professional, focused, composed and positive.
• Excellent customer service skills
• Displays integrity, friendliness, and compassion.
• Must be able to establish an appropriate and effective rapport with others.
• Demonstrates flexibility
• Takes initiative
• Able to work in a fast-paced environment
• Embraces new opportunities to grow both personally and professionally.
• Effective critical thinking and problem-solving skills.
• Proficient with various Microsoft Office products (Word and Excel).
• Strong organizational skills.
• Effective interpersonal skills.
• Ability to take and follow direction in a positive and appropriate manner.
• Ability to work as part of a team and independently. Must be able to demonstrate effective and appropriate written and oral communication skills.
• Must be able to speak, read, write and follow instructions in English