Patient Benefit Rep

About the role

We are seeking an experienced Patient Benefits Representative to join a growing healthcare team. This position plays a vital role in helping patients understand their insurance coverage, treatment costs, financial responsibilities, and available assistance programs before receiving care.

Key Responsibilities

• Verify insurance eligibility, benefits, and coverage information prior to treatment
• Educate patients regarding co-pays, deductibles, coinsurance, and out-of-pocket expenses
• Explain insurance coverage and financial responsibilities
• Update and maintain accurate insurance information in the system
• Assess patients' financial ability to meet treatment expenses
• Discuss payment arrangements and financial responsibilities
• Educate patients on available financial assistance programs
• Aid in preparing patient cost estimates based on diagnosis, insurance coverage, and financial assistance options
• Obtain insurance pre-authorizations and referral approvals prior to treatment
• Coordinate with clinical reviewers and billing teams to secure approvals
• Process reimbursement and liability forms as required
• Manage patient accounts, ensuring accurate co-pay information is entered into the system
• Verify and update patient demographics and insurance information at each visit
• Maintain accurate records, logs, and documentation
• Build relationships with financial assistance organizations and aid providers
• Stay informed of available patient assistance resources
• Maintain compliance with HIPAA and healthcare confidentiality regulations

Required Qualifications

• High School Diploma or GED required
• Minimum 3 years of Patient Benefits, Patient Access, Insurance Verification, Prior Authorization, Financial Counseling, or related healthcare experience
• Strong understanding of health insurance plans and benefits
• Experience obtaining insurance authorizations and referrals
• Proficiency with Microsoft Office (Word and Excel)
• Strong communication and customer service skills
• Ability to discuss financial matters professionally and compassionately with patients
• Strong attention to detail and documentation accuracy
• Knowledge of healthcare insurance processes and reimbursement requirements
• Ability to work independently in a fast-paced healthcare environment

Preferred Qualifications

• Oncology or specialty healthcare experience
• EMR/EHR experience
• Knowledge of CPT and HCPCS coding
• Experience with financial assistance programs
• Exposure to medical billing and reimbursement processes

What Success Looks Like

• Insurance verification and benefit investigation expertise
• Strong prior authorization and referral experience
• Excellent patient communication and customer service
• Ability to explain financial responsibilities clearly
• Strong attention to detail and documentation accuracy
• Knowledge of healthcare insurance processes and reimbursement requirements
• Ability to work independently in a fast-paced healthcare environment

Why Consider This Opportunity?

• Stable Monday–Friday schedule
• Contract-to-hire opportunity with long-term potential
• Competitive compensation
• Opportunity to make a direct impact on patient care and treatment access
• Professional healthcare environment with career growth opportunities