Patient Benefits Representative Sr.

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology in Cypress, Texas. As 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 across 280+ sites in Texas. Our mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care, helping patients achieve "More breakthroughs. More victories." in their fight against cancer.

About the role

This full-time position supports the Oncology Department at our 21216 Northwest Freeway #140 clinic. The position level (Level 1 or Senior) will depend on the candidate's relevant experience.

Responsibilities

• Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses prior to treatment.
• Obtain insurance coverage information and demographics; assess patients' ability to meet expenses and discuss payment arrangements.
• Educate patients on financial assistance programs, identify sources, and assist with completing forms.
• Complete Patient Cost Estimate form based on diagnosis, estimated insurance coverage, and financial assistance.
• Complete reimbursement and liability forms for patient review and signature; forward information to the billing office.
• Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
• Review patient account balances and notify the front desk of patients to meet with.
• Ensure patient co-pay amounts are correctly entered into the system for front desk collection.
• Verify and update patient demographics and insurance coverage in the computer system at each visit according to SOPs.
• Stay current on available financial aid; develop professional relationships with financial aid providers.
• Network with financial aid providers 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 or assigned.

Requirements

• High school diploma or equivalent required.
• Proficiency with computer systems and Microsoft Office (Word and Excel).
• Demonstrate knowledge of CPT coding and HCPCS coding application.
• Must be able to verbally communicate clearly using appropriate terminology.
• Must successfully complete required e-learning courses within 90 days of occupying the position.

Qualifications

Level 1:

• Minimum three (3) years of patient pre-services coordinator or equivalent experience.

Senior Level (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.
• 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.
• Demonstrates Adaptability: Handles day-to-day work challenges confidently; adjusts to shifting priorities, ambiguity, and rapid change; shows resilience in the face of constraints or adversity.
• Uses Sound Judgment: Makes timely, cost-effective, and sound decisions, even 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 delivering quality products/services; defines and evaluates quality standards; improves efficiencies.

Physical Demands

• Regularly required to sit or stand, talk, or hear during scheduled business hours.
• 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.
• Involves in-person interaction with co-workers, management, and clients.
• May require minimal travel by automobile to office sites.

Schedule

Monday through Friday, 8:00 AM – 4:30 PM.