Patient Benefits Representative

About the role

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full-time position will support the Medical Oncology Department (Patient Facing) at our 2410 Round Rock Avenue #150 clinic in Round Rock, Texas. Typical work week is Monday through Friday, 8:30a - 5:00p.

Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas. Our mission is to use 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.

Responsibilities

The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing patients' financial ability, and updating and maintaining existing patient insurance eligibility, coverage, and benefits in the system.

• Prior to a patient receiving treatment, obtains insurance coverage information and demographics and educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assesses patients' ability to meet expenses and discusses payment arrangements.
• May educate patients on financial assistance programs and identify sources and provide assistance with completing forms.
• Completes Patient Cost Estimate form based on diagnosis, estimated insurance coverage, and financial assistance.
• Completes appropriate reimbursement and liability forms for patient’s review and signature.
• Obtains insurance pre-authorization or referral approval codes prior to each treatment.
• Reviews patient account balance and notifies front desk of patients to meet with.
• Verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
• Stays current on available financial aid and develops professional relationships with financial aid providers.

Qualifications

The ideal candidate for the Patient Benefits Representative will have the following background and experience:

• Level 1: High school diploma or equivalent required, minimum three years patient pre-services coordinator or equivalent required, proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Level Sr: Associates degree in Finance, Business or four years revenue cycle experience preferred, minimum three years pre-services coordinator experience and two years of patient benefits experience required.

The candidate should demonstrate knowledge of CPT coding and HCPS coding application, be able to verbally communicate clearly, and utilize the appropriate and correct terminology.

Skills

• Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area.
• Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change.
• 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.

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients.