Patient Benefits Representative

This full-time position supports the Medical Oncology Department at our 1401 Medical Parkway, Building C Suite 200 clinic in Cedar Park, Texas, with travel to Marble Falls.

About the role

This is an opportunity to work alongside a highly engaged team that values teamwork, respect, and excellence in patient care. We are dedicated to creating a positive workplace culture where employees are supported, recognized for their contributions, and encouraged to develop their skills while serving our patients and community. This position will be a level 1 or Senior depending on relevant candidate experience.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country, with approximately 530 providers in 280+ sites across Texas. Our founders pioneered community-based cancer care to make the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission remains the same today—using leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.” in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer annually.

The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America, supported by McKesson Corporation to empower a vibrant and sustainable community patient care delivery system.

Responsibilities

• Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients' ability to meet expenses and discuss payment arrangements; educate patients on financial assistance programs and assist with completing forms.
• Based upon diagnosis, estimated insurance coverage, and financial assistance, complete Patient Cost Estimate form.
• Complete appropriate reimbursement and liability forms for patient’s review and signature; forward information to billing office.
• Obtain insurance pre-authorization or referral approval codes from Clinical Reviewer prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with.
• Ensure patient co-pay amount is correctly entered into system (or conveyed) to allow front desk to collect appropriately.
• At each patient visit, verify and update demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
• Stay current on available financial aid; develop professional relationships with financial aid providers and network to obtain leads to other aid programs.
• Adhere to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
• Maintain updated manuals, logs, forms, and documentation.
• Perform additional duties as requested.

Requirements

The ideal candidate will meet the following qualifications:

• Level 1:
  • High school diploma or equivalent required.
  • Minimum three (3) years patient pre-services coordinator or equivalent experience required.
  • Proficiency with computer systems and Microsoft Office (Word and Excel) required.
  • Demonstrate knowledge of CPT coding and HCPCS coding application.
  • Must be able to verbally communicate clearly and use appropriate terminology.
  • Must successfully complete required e-learning courses within 90 days of occupying position.
• Senior Level (in addition to Level 1 requirements):
  • Associate’s degree in Finance, Business, or four years revenue cycle experience preferred.
  • Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
  • Must demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Skills

• Uses Technical and Functional Experience: Possesses up-to-date knowledge of the profession and industry; regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.
• Demonstrates Adaptability: Handles day-to-day work challenges confidently; adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.
• Uses Sound Judgment: Makes timely, cost-effective, and sound decisions; makes decisions under conditions of uncertainty.
• Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.
• Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and service against those standards; manages quality; improves efficiencies.

Physical Demands

• While performing the duties of this job, the employee is required to be present at the worksite during regularly scheduled business hours and regularly required to sit or stand, talk, or hear.
• Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.
• Requires standing and walking for extensive periods of time.
• Occasionally lifts and carries items weighing up to 40 lbs.
• Requires corrected vision and hearing to normal range.

Work Environment

• May include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic environment.
• Involves in-person interaction with co-workers, management, and/or clients.
• May require minimal travel by automobile to office sites.

Schedule

Typical work week is Monday through Friday, 8:30 AM – 5:00 PM.