Patient Benefit Representative team lead

The US Oncology Network • Bedford, TX

5h • Onsite

About The Position

The US Oncology Network is looking for a Patient Benefits Representative Lead to join our team at Texas Oncology. This full-time position will support the Revenue Cycle Department at our 1609 Hospital Parkway clinic in Bedford, Texas with possible travel to Grapevine and Keller. Typical work week is Monday through Friday, 8:00a - 5:00p.
Note from Hiring Manager: We have a great team. Texas Oncology is a great company to work for!
As a 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 and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.” ® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.
The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.
What does the Patient Benefits Representative Lead do? (including, but not limited to)
With minimal supervision, responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Trains and supports onboarding of PBR new hires. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Requirements

• High school diploma or equivalent required
• Minimum 3 years of Patient Benefits experience required.
• Must be able to demonstrate knowledge of CPT coding and HCPS coding manuals.
• Must verbally communicate clearly and utilize the appropriate and correct terminology.
• Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology

Nice To Haves

• Associates degree in Finance/Business or 6 years of revenue cycle experience preferred

Responsibilities

• Prior to a patients first appointment, obtains preliminary diagnosis, insurance coverage information and demographics. Based upon diagnosis, estimates insurance coverage, financial obligation, and completes patient cost estimate forms. Prepares and completes appropriate reimbursement and liability forms for patients first appointment.
• During patients first appointment, educates patient on insurance coverage, pre-authorizations, benefits, co-pays, deductibles, and out-of-pocket expenses. Assess patients ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Reviews reimbursement and liability forms with patient and obtains approval signatures.
• Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Maintains current knowledge on TxO Standard Operating Procedures (SOPs) and best practices, and supports the on the job training and onboading of new PBR staff.
• Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
• Reviews and processes refund requests and adjustments. May discuss and resolve delinquent payments with patient and/or payers. -At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
• Maintains updated manuals, logs, forms, and documentation. Performs additional duties requested. Other duties as requested or assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees