Pre-Service Specialist II

Albany Medical Center; City of Hudson (NY); On-site; USD 47,000 - 66,000; Full time

Job summary

Albany Medical Center is seeking a Pre-Service Specialist II in our Patient Access department to provide an exceptional patient experience. The role involves scheduling complex services for our hospital and practice, and verifying insurance eligibility to ensure financial clearance.

The position requires empathetic communication, ability to work in a high-volume contact center, and knowledge of payer guidelines to interpret benefits and collect patient financial obligations prior to service.

Qualifications

• High School Diploma or GED required.
• Experience in hospital, physician office, or call center preferred.
• Strong knowledge of insurance payer authorization guidelines.
• Ability to work in a high-volume environment and maintain accuracy.

Responsibilities

• Schedule appointments and services for multiple service lines via scheduling system.
• Identify trigger words and triage calls to the Nursing team per protocol.
• Verify demographic and insurance information for accurate registration.
• Interpret payer eligibility responses and applicable contractual benefits.
• Discuss and collect patient financial obligations pre-services.
• Review services to ensure appropriate setting of care.
• Obtain and verify insurance information to ensure active coverage.
• Maintain HIPAA-compliant handling of patient information.
• Train adult learners using operational training material.

Skills

Customer service

Insurance knowledge

Scheduling

Communication skills

Multitasking

Education

High School Diploma/G.E.D.

Job description

Department/Unit:

Patient Access

Work Shift:

Day (United States of America)

Salary Range:

$46,947.00 - $65,726.00

The Pre-Service Specialist II (PSS II) is the initial point of contact for our patient population to provide an exceptional patient experience with assisting in scheduling of the more complex services for our Hospital and Practice. Strong knowledge of insurance payer authorization guidelines is critical for the financial clearance and payment of services. Position requires ability to work in a high-volume contact center, fast-paced environment. Understanding complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services.

Essential Duties and Responsibilities

• Responsible for scheduling appointments and services for multiple service lines (PODs) via the scheduling system following established scripting and protocols promoting physician satisfaction and scheduling efficiencies on behalf of our patients.
• Ability to identify trigger words, symptoms and patient concerns, assuring calls are triaged to the respective Clinic Nursing team per protocol.
• Responsible for discerning demographic and insurance information to ensure accurate registration
• Responsible to interpret information received from Insurance Payer regarding patient’s eligibility and financial responsibility
• Responsible for discussing financial obligation of patient and collect via cash, credit card or check
• Ability to accurately interpret referral/physician order to meet the patient and/or provider need for scheduling of services correctly.
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital and practice pre-registration.
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
• Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician’s office
• Obtains all insurance information from patient and verifies insurance to ensure active coverage for services being scheduling.
• Provides thorough comments, where applicable for all conversations with patients or providers.
• Ability to train adult learners using an operational training manual

Qualifications

• High School Diploma/G.E.D. - required
• Winning customer service personality with ability to engage patients, provider and provider staff as well as insurance company representatives via telephone with superior patient experience.
• 3– 5 years’ experience in Hospital or Physician office experience or call center environment, - preferred
• Strong insurance knowledge specific to complex scheduling needs and authorization management
• Critical thinking ability
• Ability to provide cross coverage where and as needed
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit
• Must be able to manage daily productivity, quality and accuracy targets
• Ability to maintain composure under pressure
• Ability to review information and draw appropriate conclusionGood judgement and ability to be resourceful to problem solve; elevate issues as needed
• Team minded work ethic
• Demonstrated ability interpret patient’s insurance benefits and apply the applicable contractual obligations

Equivalent combination of relevant education and experience may be substituted as appropriate.

Physical Demands

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Constantly
• Hearing - Constantly
• Repetitive Motions - Constantly
• Eye/Hand/Foot Coordination - Constantly

Thank you for your interest in Albany Medical Center!

Albany Medical Center is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Thank you for your interest in Albany Med Health System!

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.