Patient Benefits Representative

The US Oncology Network•Chicago, IL

6d•Onsite

About The Position

The Patient Benefits Representative works under general supervision to educate patients about insurance coverage and benefits, assess their ability to meet financial obligations, and provide information about assistance programs. The role updates and maintains patient insurance eligibility, coverage, and benefits in the system, and supports the US Oncology Compliance Program, including its Code of Ethics, Business Standards, and Shared Values. This is a full-time, Monday-through-Friday position at 7447 W Talcott Ave, Chicago, IL, with an hourly rate of $22–$26. Benefits listed include a 401(k), HSA, medical, dental, vision, and the Vitality Perks Program.

Requirements

High school diploma or equivalent.
Minimum of three years of patient pre-services coordinator experience or equivalent.
Proficiency with computer systems and Microsoft Word and Excel.
Knowledge of CPT coding and HCPS coding application.
Ability to communicate clearly verbally and use appropriate, correct terminology.
Successfully complete required e-learning courses within 90 days of occupying the position.
Demonstrate current technical and functional knowledge of the profession and industry, and use expert resources when appropriate.
Handle day-to-day work challenges confidently and adapt to multiple demands, shifting priorities, ambiguity, and rapid change.
Make timely, cost-effective, and sound decisions, including under conditions of uncertainty.
Set high performance standards, pursue challenging goals, and work efficiently to achieve them.
Emphasize quality of service, define and evaluate quality standards, manage quality, and improve efficiency.

Responsibilities

Verify active insurance coverage, benefits, and pre-authorization requirements before patient services.
Coordinate, track, and secure necessary referrals and primary care authorizations in a timely manner.
Meet with patients to discuss financial responsibilities, review outstanding insurance balances, and present payment options or financial assistance programs.
Identify underinsured or financially constrained patients and research, apply for, and secure charitable grants, disease-specific foundation support, and manufacturer copay assistance.
Obtain insurance coverage information and patient demographics before treatment; educate patients about coverage, benefits, copays, deductibles, and out-of-pocket expenses.
Assess patients’ ability to meet expenses and discuss payment arrangements.
Educate patients about financial assistance programs, identify potential assistance sources, and help patients complete forms.
Complete Patient Cost Estimate forms based on diagnosis, estimated insurance coverage, and financial assistance.
Complete appropriate reimbursement and liability forms for patient review and signature.
Forward appropriate information and forms to the billing office.
Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer before each treatment.
Review patient account balances and notify the front desk about patients who need to meet with providers.
Ensure patient copay amounts are correctly entered in the system or conveyed to the front desk for collection.
Verify and update patient demographics and insurance coverage in computer systems at each visit, following Standard Operating Procedures.
Stay current on available financial aid and develop professional relationships with financial aid providers.
Network with financial aid providers to obtain leads to other assistance programs.
Maintain confidentiality and comply with state and federal laws and guidelines regarding patient records.
Maintain updated manuals, logs, forms, and documentation.
Perform other duties as requested or assigned.
Support and adhere to the US Oncology Compliance Program, including its Code of Ethics and Business Standards and Shared Values.