Patient Benefits Representative

The US Oncology Network•Plano, TX

2d•Onsite

About The Position

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full-time position will support the Urology Department at our 4708 Alliance Blvd #150 clinic in Plano, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. Note from Hiring Manager: Texas Urology Specialists offers a supportive, patient-centered environment where Patient Benefit Coordinators play a key role in helping patients navigate their care with confidence. Team members are valued for their expertise, collaboration, and commitment to exceptional service, with opportunities to grow within a respected and stable specialty practice. Our focus on quality care, teamwork, and work–life balance makes this a rewarding place to build a long-term career. This position will be a level 1or Sr depending on relevant candidate experience. 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 do? (including, but not limited to): The Patient Benefits Representative, under general supervision is 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. Supports and adheres to the US Oncology Compliance Program, to include 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.
Associates degree in Finance, Business or four years revenue cycle experience preferred.
Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Responsibilities

Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, 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. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
Completes appropriate reimbursement and liability forms for patient’s review and signature. Forwards appropriate information and forms to billing office.
Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
Review patient account balance and notify front desk of patients to meet with
Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
Stays current on available financial aide. Develops professional relationships with financial aide providers. Networks with financial aide providers to obtain leads to other aide programs.
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients records.
Maintains updated manuals, logs, forms, and documentation.
Performs additional duties as requested.
Other duties as requested or assigned.