Pre-Service Representative

St. Mary's Healthcare•Amsterdam, NY

About The Position

St. Mary’s Healthcare is hiring a full-time Pre-Service Representative for a 40-hour workweek on the day shift. The role supports patient access and clinical workflows by answering calls, scheduling diagnostic procedures, communicating preparation and financial information, and completing patient preregistration and insurance verification. The representative works with patients, referring providers, Medical Imaging staff, surgical schedulers, and other parties, while maintaining patient confidentiality and complying with HIPAA and applicable policies. The hiring range is $18.74–$25.07. Additional shift differentials apply to eligible evening, night, and weekend shifts. Actual compensation depends on experience and other factors permitted by law.

Requirements

High school diploma or GED.
At least two years of experience in a hospital or physician-office setting in a patient access position or call-center environment, or equivalent.
Strong insurance knowledge specific to complex scheduling needs and authorization management.
At least six months of computer experience.
Obtain Certified Patient Financial Specialist – HBI certification within six months of hire.
Ability to organize and establish daily priorities using critical thinking.
Ability to multitask while remaining professional, focused, composed, and positive.
Excellent customer service skills; integrity, friendliness, and compassion.
Ability to establish effective rapport, demonstrate flexibility, and take initiative in a fast-paced environment.
Effective critical-thinking and problem-solving skills.
Proficiency with Microsoft Office products, including Word and Excel.
Strong organizational and interpersonal skills.
Ability to take and follow direction appropriately and work both independently and as part of a team.
Effective written and oral communication skills.
Ability to speak, read, write, and follow instructions in English.

Nice To Haves

Familiarity with medical terminology; preferred but not required.

Responsibilities

Answer incoming calls, assess callers’ needs, and direct them to the appropriate unit.
Schedule diagnostic patient procedures based on provider referrals or referrals presented by patients.
Optimize exam scheduling by equipment, time, and location; review open slots and manage the waitlist in Expanse.
Communicate preparation instructions and financial clearance information to patients as required.
Coordinate with Medical Imaging staff, surgical schedulers, doctors’ offices, and other providers.
Communicate schedule changes, STAT requests, nurse requirements, and add-ons to appropriate parties.
Open faxes from the scheduling fax service and rename them using standard nomenclature.
Preregister patient accounts in the EMR by verifying demographic information and insurance eligibility with patients by phone.
Understand and apply contractual benefits to services and collect patient financial obligations before services when applicable.
Use eligibility applications and authorization portals to verify insurance eligibility, interpret responses, and capture relevant insurance information.
Document payer communications and pre-service financial conversations, including payer decisions, collection attempts, and payment plan arrangements.
Meet department productivity and quality metrics.
Work across multiple systems during calls or patient-facing interactions to complete accurate registration and support clinical workflows.
Follow policies, procedures, and legal requirements concerning protected health information and HIPAA, and maintain patient confidentiality.