Patient Benefit Specialist

The US Oncology Network•Merrifield, VA

6d•Onsite

About The Position

Virginia Cancer Specialists, affiliated with McKesson Specialty Health and US Oncology, is hiring an experienced full-time Patient Benefit Specialist for its Fairfax office. Under general supervision, this role handles insurance verification and eligibility, assesses patients’ financial requirements, counsels patients about insurance benefits and co-payments, obtains service pre-authorizations, and maintains accurate patient demographics. The specialist supports and adheres to the US Oncology Compliance Program, including its Code of Ethics and Business Standards. The position is performed in an office environment and involves frequent interaction with staff, patients, and the public. The role requires prolonged sitting and computer use, as well as occasional stooping, bending, stretching, and lifting files or paper weighing up to 30 pounds. The employee must be able to operate common office equipment and have vision correctable to 20/20 and hearing in the normal range for telephone contacts. Reasonable accommodations may be made for individuals with disabilities.

Requirements

High school diploma or equivalent.
At least three years of medical business office experience involving insurance procedures and patient interaction.
Ability to meet the physical demands described, including prolonged sitting and computer use, occasional lifting of files or paper weighing up to 30 pounds, and operation of office equipment.
Vision correctable to 20/20 and hearing in the normal range for telephone contacts.

Responsibilities

Obtain and accurately enter insurance, demographic, and eligibility information into the system.
Verify insurance with third-party payers and obtain initial and subsequent pre-authorizations for services and surgeries.
Re-verify benefits and obtain authorization or referrals after the treatment plan is discussed and before treatment begins; ensure required forms are signed.
Use the Summary of Patient Reimbursement and Liability form and obtain required approvals.
Conduct financial counseling before treatment, explaining patient financial obligations and billing practices and establishing payment arrangements.
Document financial counseling and forward the documentation to the Billing Office.
Help patients obtain financial assistance, such as Medicaid or drug replacement, and outside assistance, such as transportation or community services; complete applicable forms.
Collect co-pays, deductibles, and other out-of-pocket amounts at the time of the visit.
Help maintain manuals, logs, and other required documentation.
Protect patient confidentiality.
Follow policies and procedures that support front-office efficiency; cover and assist with other front-office functions as requested.
Support and adhere to the US Oncology Compliance Program, including its Code of Ethics and Business Standards.