Patient Benefits Representative Team Lead-Radiation
About The Position
The US Oncology Network is seeking a full-time Patient Benefits Representative Lead for Texas Oncology’s Radiation Oncology Department at its clinic in Plano, Texas. The typical workweek is Monday through Friday, 7:30 a.m. to 4:00 p.m. The role educates patients about insurance coverage and benefits, assesses their ability to meet financial obligations, and may provide information about assistance programs. It maintains patient insurance eligibility, coverage, and benefits information in the system, and trains and supports onboarding of new Patient Benefits Representative staff. The position also supports and adheres to the US Oncology Compliance Program, including its Code of Ethics and Business Standards.
Requirements
- High school diploma or equivalent required.
- At least 3 years of Patient Benefits experience required.
- Ability to demonstrate knowledge of CPT coding and HCPS coding manuals.
- Ability to communicate clearly verbally and use appropriate, correct terminology.
- Ability to demonstrate knowledge and appropriate application of insurance coverage, benefits, and terminology.
- Ability to meet the physical demands of the role, including sitting or standing, talking or hearing, handling and lifting patients, extensive standing and walking, and occasionally lifting or carrying items weighing up to 40 pounds.
- Corrected vision and hearing within the normal range.
Nice To Haves
- Associate degree in Finance or Business, or 6 years of revenue cycle experience, preferred.
Responsibilities
- Before a patient’s first appointment, obtain preliminary diagnosis, insurance coverage information, and demographics; estimate insurance coverage and patient financial obligation; and complete patient cost estimate, reimbursement, and liability forms.
- At a patient’s first appointment, explain insurance coverage, pre-authorizations, benefits, co-pays, deductibles, and out-of-pocket expenses; assess the patient’s ability to meet expenses; and discuss payment arrangements.
- Provide information about financial assistance programs, identify possible assistance sources, and help patients complete forms when appropriate.
- Review reimbursement and liability forms with patients and obtain approval signatures.
- Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer before each treatment.
- Maintain knowledge of Texas Oncology standard operating procedures and best practices, and support on-the-job training and onboarding of new Patient Benefits Representative staff.
- Ensure patient co-pay amounts are correctly entered into the system or communicated so the front desk can collect them appropriately.
- Review and process refund requests and adjustments; may discuss and resolve delinquent payments with patients or payers.
- At each patient visit, verify and update demographics and insurance coverage in the computer system according to standard operating procedures.
- Maintain current manuals, logs, forms, and documentation; perform other duties as requested or assigned.
- Support and adhere to the US Oncology Compliance Program, including the Code of Ethics and Business Standards.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
