Billing Representative

Healthcare Billing Specialist

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 15 years ago. Employment Type: Full-time Shift: Days Hours: 40-hours/Week Hiring range: $19.64 - $24.07

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.

Primary Job Responsibilities:

• Confirms insurance coverage. Verify if authorizations have been obtained for scheduled procedures.
• Determines financial responsibility for services to be provided. Notifies appropriate department/physician practices of any services requested and/or referred that are not authorized by insurance.
• Communicates with patients and appropriate department/physician practices regarding financial responsibility and insurance coverage issues following department specific guidelines. Responsible for reviewing and processes all correspondence.
• Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claim's reconciliation process. Assures timely filing of original and corrected claims to prevent write-offs.
• Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self-payers. Researches, analyzes, and reconciles Medicare/Medicaid billing and reimbursement practices.
• Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.

Minimum Qualifications:

Education, Training, & Experience:

• High school diploma or GED required. Minimum one (1) year healthcare medical billing experience preferred.

Certifications/Licensure:

• Certified Patient Financial Services Specialist 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.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.