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 at our 7200 Highway 161, Suite 300 clinic in Irving, 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 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, and 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, and forwards information and forms to billing office.
• Obtains insurance pre-authorization or referral approval codes prior to each treatment, and reviews patient account balance and notifies front desk of patients to meet with.
• Verifies and updates demographics and insurance coverage in computer system at each patient visit, and stays current on available financial aid.
• Develops professional relationships with financial aid providers, and networks with financial aid providers to obtain leads to other aid programs.

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, and be able to verbally communicate clearly and utilize the appropriate and correct terminology.

Skills

The candidate should possess the following skills:

• Technical and functional expertise, with up-to-date knowledge of the profession and industry.
• Adaptability, with the ability to handle day-to-day work challenges confidently and adjust to multiple demands, shifting priorities, ambiguity, and rapid change.
• Sound judgment, with the ability to make timely, cost-effective, and sound decisions under conditions of uncertainty.
• Work commitment, with high standards of performance and a willingness to pursue aggressive goals and work efficiently to achieve them.
• Commitment to quality, with an emphasis on delivering quality products and/or services and defining standards for quality and evaluating products, processes, and services against those standards.

Physical Demands and Work Environment

The physical demands of this job include being present at the employee site during regularly scheduled business hours, sitting or standing and talking or hearing, and requiring full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.

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, and may require minimal travel by automobile to office sites.