Patient Benefits Representative

Overview

The US Oncology Network is seeking a Patient Benefits Representative to join the Texas Oncology team at the 2121 Pease #101 clinic in Harlingen, TX. This full‑time role supports the Medical and Radiation Oncology Departments. The position may be classified as Level 1 or Senior (Level Sr) depending on the candidate’s experience. Texas Oncology is the largest community oncology provider in the United States, delivering high‑quality, evidence‑based cancer care across more than 280 sites in Texas.

Schedule

Monday through Friday, 8:00 a.m. – 5:00 p.m.

Responsibilities

• Obtain insurance coverage information and demographics prior to treatment; educate patients on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
• Assess patients’ ability to meet expenses, discuss payment arrangements, and educate them on financial assistance programs, including completing necessary forms.
• Complete the Patient Cost Estimate form based on diagnosis, estimated insurance coverage, and financial assistance.
• Prepare appropriate reimbursement and liability forms for patient review and signature, then forward them to the billing office.
• Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer before each treatment.
• Review patient account balances and notify the front desk when patients need to meet with billing staff.
• Ensure patient co‑pay amounts are correctly entered into the system (or conveyed) so the front desk can collect appropriately.
• Verify and update demographics and insurance coverage in the computer system at each patient visit according to Standard Operating Procedures (SOPs).
• Stay current on available financial aid options; develop professional relationships with financial‑aid providers and network to obtain leads to additional programs.
• Adhere to confidentiality, state, federal, and HIPAA regulations regarding patient records.
• Maintain updated manuals, logs, forms, and documentation.
• Perform additional duties as requested.

Qualifications

• Level 1
  • High school diploma or equivalent (required).
  • Minimum three (3) years of patient pre‑services coordinator experience or equivalent (required).
  • Proficiency with computer systems and Microsoft Office (Word and Excel) (required).
  • Knowledge of CPT coding and HCPCS coding application.
  • Clear verbal communication using appropriate terminology.
  • Successful completion of required e‑learning courses within 90 days of occupying the position.
• Level Sr (in addition to Level 1 requirements)
  • Associate’s degree in Finance, Business, or four years of revenue‑cycle experience (preferred).
  • Minimum three (3) years of pre‑services coordinator experience and two (2) years of patient benefits experience (required).
  • Demonstrated knowledge and appropriate application of insurance coverage benefits and terminology.

Competencies

• Uses technical and functional expertise; regarded as an expert in the area and accesses additional resources when appropriate.
• Demonstrates adaptability; handles day‑to‑day challenges, adjusts to shifting priorities, and shows resilience under constraints.
• Uses sound judgment; makes timely, cost‑effective decisions, even under uncertainty.
• Shows work commitment; sets high performance standards and pursues aggressive goals efficiently.
• Commits to quality; defines and evaluates standards, manages quality, and seeks process improvements.

Physical Demands

The role requires regular presence at the clinic during scheduled business hours, with frequent sitting, standing, walking, and talking. Employees must be able to handle a full range of body motions, including lifting patients or items up to 40 lb, and possess adequate manual dexterity, eye‑hand coordination, and corrected vision and hearing within normal ranges. Reasonable accommodations may be provided for individuals with disabilities.

Work Environment

The work environment includes exposure to communicable diseases, toxic substances, ionizing radiation, and medical preparations typical of an oncology/hematology clinic. The position involves in‑person interaction with co‑workers, management, and patients, and may require minimal automobile travel between office sites.