Patient Benefit Rep

TEKsystems•Silver Spring, MD

2d•$18 - $26•Onsite

About The Position

We are seeking an experienced Patient Benefits Representative to join a growing healthcare team. This position plays a vital role in helping patients understand their insurance coverage, treatment costs, financial responsibilities, and available assistance programs before receiving care. The ideal candidate will have experience with insurance verification, prior authorizations, patient benefits, financial counseling, or patient access functions and be passionate about helping patients navigate the healthcare system.

Requirements

High School Diploma or GED required
Minimum 3 years of Patient Benefits, Patient Access, Insurance Verification, Prior Authorization, Financial Counseling, or related healthcare experience
Strong understanding of health insurance plans and benefits
Experience obtaining insurance authorizations and referrals
Proficiency with Microsoft Office (Word and Excel)
Strong communication and customer service skills
Ability to discuss financial matters professionally and compassionately with patients

Nice To Haves

Oncology or specialty healthcare experience
EMR/EHR experience
Knowledge of CPT and HCPCS coding
Experience with financial assistance programs
Exposure to medical billing and reimbursement processes

Responsibilities

Verify insurance eligibility, benefits, and coverage information prior to treatment
Educate patients regarding co-pays, deductibles, coinsurance, and out-of-pocket expenses
Explain insurance coverage and financial responsibilities
Update and maintain accurate insurance information in the system
Assess patients' financial ability to meet treatment expenses
Discuss payment arrangements and financial responsibilities
Educate patients on available financial assistance programs
Assist patients in completing financial assistance applications and required paperwork
Prepare patient cost estimates based on diagnosis, insurance coverage, and financial assistance options
Obtain insurance pre-authorizations and referral approvals prior to treatment
Coordinate with clinical reviewers and billing teams to secure approvals
Process reimbursement and liability forms as required
Review patient account balances and identify outstanding responsibilities
Ensure accurate co-pay information is entered into the system
Verify and update patient demographics and insurance information at each visit
Maintain accurate records, logs, and documentation
Build relationships with financial assistance organizations and aid providers
Stay informed of available patient assistance resources
Maintain compliance with HIPAA and healthcare confidentiality regulations