Patient Benefits Representative

Responsibilities

• Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket costs prior to treatment
• Assess patients’ financial ability to meet expenses and discuss payment options or arrangements
• Provide guidance on financial assistance programs and assist with application processes
• Prepare accurate patient cost estimates based on diagnosis, insurance coverage, and available assistance
• Verify and update patient insurance eligibility, coverage, and demographics in the system
• Absorb and obtain insurance pre-authorizations and referral approvals prior to treatment
• Ensure accurate entry of co-pay amounts to support front desk collections
• Review patient balances and coordinate with front desk on patient financial discussions
• Verify and update patient information at each visit in accordance with SOPs
• Complete and route required reimbursement and liability forms
• Stay current on available financial assistance programs and maintain relationships with providers
• Adhere to all HIPAA, confidentiality, and compliance guidelines
• Support and uphold the US Oncology Compliance Program, Code of Ethics, and Shared Values
• Maintain accurate documentation, logs, and records
• Aid with additional duties and projects as needed

Qualifications

• High school diploma or equivalent
• Minimum of 3 years of experience in patient pre-services, financial counseling, or a related role
• Strong knowledge of insurance processes and patient financial workflows
• Proficiency in Microsoft Office (Word, Excel) and computer systems
• Working knowledge of CPT and HCPCS coding

Skills & Abilities

• Excellent communication skills with the ability to explain complex information in a clear, compassionate manner
• Strong attention to detail and organizational skills
• Ability to multitask and manage changing priorities in a fast-paced environment