Patient Benefits Representative Sr

The US Oncology Network•Shenandoah, TX

7d•Onsite

About The Position

The Patient Benefits Representative works under general supervision to educate patients about their insurance coverage and benefits, assess their ability to meet healthcare expenses, and provide information about assistance programs. The role maintains current patient insurance eligibility, coverage, and benefits in the system and supports The US Oncology Network Compliance Program, Code of Ethics and Business Standards, and Shared Values. This full-time position supports the Oncology Department at Texas Oncology’s clinic at 920 Medical Plaza Drive, Suite 100, Shenandoah, Texas. The typical schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m. The position may be hired at Level 1 or Senior, depending on relevant experience. Texas Oncology is part of The US Oncology Network, a community-based oncology network supported by McKesson Corporation. Texas Oncology provides evidence-based cancer care through a network of providers and sites across Texas.

Requirements

High school diploma or equivalent.
At least three years of patient pre-services coordinator or equivalent experience.
Proficiency with computer systems and Microsoft Word and Excel.
Knowledge of CPT coding and HCPCS coding application.
Ability to communicate clearly and use appropriate terminology.
Successfully complete required e-learning courses within 90 days of occupying the position.
For the Senior level: at least three years of pre-services coordinator experience and two years of patient benefits experience.
For the Senior level: demonstrate knowledge and appropriate application of insurance coverage, benefits, and terminology.

Nice To Haves

For the Senior level: an associate degree in Finance or Business, or four years of revenue cycle experience.

Responsibilities

Before treatment, obtain patient insurance coverage information and demographics, and explain coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
Assess patients’ ability to meet expenses and discuss payment arrangements.
Educate patients about financial assistance programs, identify sources of assistance, and help patients complete forms.
Complete Patient Cost Estimate forms based on diagnosis, estimated insurance coverage, and financial assistance.
Complete reimbursement and liability forms for patient review and signature, and forward the 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 which patients should meet with staff.
Ensure patient co-pay amounts are correctly entered in the system or communicated so the front desk can collect them appropriately.
At each visit, verify and update patient demographics and insurance coverage in the computer system according to standard operating procedures.
Stay current on financial assistance and develop professional relationships with assistance providers to identify additional program leads.
Protect patient records in accordance with confidentiality requirements and applicable state, federal, and HIPAA laws and guidelines.
Maintain current manuals, logs, forms, and documentation.
Perform additional duties as requested or assigned.