Patient Benefit Rep

The US Oncology Network•Panama City, FL

2d•Onsite

About The Position

Under general supervision, this role is responsible for educating patients on their insurance coverage and benefits. The Patient Benefit Rep will assess patients' financial abilities and may educate them on assistance programs. This position involves updating and maintaining existing patient insurance eligibility, coverage, and benefits in the system. The role also requires supporting and adhering to the US Oncology Compliance Program, including the Code of Ethics and Business Standards, and US Oncology's Shared Values.

Requirements

High school diploma or equivalent required.
Minimum three (3) years patient pre-services coordinator or equivalent required.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
Demonstrate knowledge of CPT coding and HCPS coding application.
Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.
Must successfully complete required e-learning courses within 90 days of occupying position.

Nice To Haves

Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is 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; is willing and able to adjust 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 evaluated products, processes, and service against those standards; manages quality; improves efficiencies.

Responsibilities

Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
Assess patients' ability to meet expenses and discuss payment arrangements.
May educate patients on financial assistance programs, identify sources, and provide assistance with completing forms.
Based upon diagnosis, estimated insurance coverage, and financial assistance, complete Patient Cost Estimate form. Complete appropriate reimbursement and liability forms for patients' review and signature. Forward appropriate information and forms to the billing office.
Responsible for obtaining, from the Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
Review patient account balance and notify the front desk of patients to meet with.
Ensure that patient co-pay amount is correctly entered into the system (or conveyed), allowing the front desk to collect appropriately.
At each patient visit, verify and update demographics and insurance coverage in the computer system according to Standard Operating Procedures (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 HIPPA laws and guidelines with regards to patients' records.
Maintain updated manuals, logs, forms, and documentation.
Perform additional duties as requested.
Other duties as requested or assigned.