Job Description

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: SURGI002089

Employment Type: Full-Time

Shift: Days

Hours Per Week: 40 hours/week

Hiring Range: $19.30- $25.83

Below are the shift differentials based on eligible shifts worked:

• Weekday evening shift - additional 10%
• Weekday night shift - additional 15%
• Weekend day shift - additional 10%
• Weekend evening & night shifts - additional 21%

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

Responsibilities:

• Verify patient insurance coverage, submit complete authorization requests with clinical notes and CPT/ICD-10 codes, track pending requests and follow up via payer portals or phone, manage denials and appeals, and coordinate peer-to-peer reviews when needed.
• Coordinate surgery dates based on surgeon availability and patient needs
• Confirm patient medical clearance and gather necessary documentation. Schedule pre-op and post-op appointments. Provide patients with thorough information and instructions to prepare them for surgery.
• Ensure all appropriate documentation included in the patient’s chart is accurate and follows institutional standards.
• Maintain proper etiquette when interacting with customers, including patients, their families/advocates, other St. Mary’s employees, and insurance company representatives.

Additional Responsibilities:

• Other duties as assigned.

Minimum Qualifications Education, Training & Experience:

• High school diploma/GED required. Strong knowledge of medical terminology, ICD and CPT codes required.
• Minimum of 3 years of healthcare experience in a physician practice 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.