Pre-Service Specialist II

100 Albany Med Health System; New York (NY); On-site; USD 47,000 - 66,000; Full time

Benefits offered by this job

Health insurance

Wellbeing programs

Job summary

Albany Med Health System seeks a Pre-Service Specialist II in the Patient Access department to be the first point of contact for patients, assisting in scheduling complex services and verifying insurance eligibility.

The role requires handling high-volume calls, applying payer guidelines, and collecting financial obligations with empathy and efficiency to ensure a smooth registration and patient experience.

Qualifications

• High school diploma or GED required.
• 3–5 years in hospital, physician office, or call center preferred.
• Strong knowledge of insurance and authorizations.
• Ability to multi-task in a high-volume setting.

Responsibilities

• Schedule appointments and services across multiple lines using established protocols.
• Triages calls to the appropriate clinic nursing team per protocol.
• Capture and verify demographic and insurance information.
• Discuss financial obligations and collect payment.
• Review referrals and physician orders to meet scheduling needs.
• Maintain accurate registration in the EHR and systems.

Skills

Customer service

Insurance knowledge

Communication skills

Multitasking

Empathy

Problem solving

Education

High School Diploma/G.E.D.

Tools

Scheduling system

Eligibility application

EHR systems

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 conclusion
• Good judgement and ability to be resourceful to problem solve; escape 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.

Albany Medical Center is the centerpiece of medicine, research, and medical education in New York’s Capital Region and is the area's largest private employer with more than 10,000 employees. Albany Medical Center offers excellent career opportunities in a wide range of roles in both patient care and administration. We value all our staff members and offer outstanding employee benefits including:

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

Anchored in the state’s historic capital city, Albany Medical Center offers a full range of inpatient and outpatient care and is home to the region’s largest hospital, only Level 1 adult and pediatric trauma centers, and only children’s hospital. The downtown campus also offers opportunities at Albany Medical College. Albany Medical Center, along with Columbia Memorial Health, Glens Falls Hospital, Saratoga Hospital, and the Visiting Nurses, form the Albany Med Health System, serving more than three million people over 25 counties.