PBR

Under general supervision, responsible for educating patients on insurance coverage and benefits, assessing patients’ financial ability, and maintaining insurance eligibility and coverage information in the system.

Responsibilities

• Obtain insurance coverage information and demographics prior to patient treatment; educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients’ ability to meet expenses and discuss payment arrangements; educate patients on financial assistance programs 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 Clinical Reviewer prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with.
• Ensure patient co-pay amount is correctly entered into the system or conveyed to the front desk for collection.
• Verify and update patient demographics and insurance coverage in computer systems at each visit according to Standard Operating Procedures (SOPs).
• Stay current on available financial aid; develop professional relationships with financial aid providers and network to obtain leads for additional 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.
• Minimum three (3) years of experience as a patient pre-services coordinator or equivalent.
• Proficiency with computer systems and Microsoft Office (Word and Excel).
• Knowledge of CPT coding and HCPS coding application.
• Clear verbal communication skills with appropriate and correct terminology.
• Must successfully complete required e-learning courses within 90 days of occupying the position.

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; accesses and uses other expert resources when appropriate.
• Demonstrates Adaptability: Handles day-to-day work challenges confidently; adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.
• 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; manages quality; improves efficiencies.

Physical Demands

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.

• Regularly required to be present at the employee site during scheduled business hours; required to sit or stand and talk or hear.
• 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 environment.
• Involves in-person interaction with co-workers, management, and/or clients.
• May require minimal travel by automobile to office sites.

Pay

The pay scale for this position is $15.69–$24.14 per hour. The actual hiring rate depends on factors such as prior work experience, education, job responsibilities, location, and work performance.