Pre-Service Representative

St. Mary's Healthcare•Amsterdam, NY

About The Position

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 2026 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.

Requirements

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.
6 months computer experience required.
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.

Nice To Haves

Medical terminology preferred but not required.
Familiarity with medical terminology preferred.

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.