Patient Benefits Representative

The US Oncology Network•Amarillo, TX

2d•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 healthcare expenses, and provide information about assistance programs. The representative obtains and maintains patient insurance eligibility, coverage, benefits, and demographic information in the system, and supports the US Oncology Compliance Program, Code of Ethics and Business Standards, and Shared Values. This full-time role supports the Medical Oncology Department at the Texas Oncology clinic at 1826 Point West Parkway in Amarillo, Texas. The typical schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. The position may be filled at Level 1 or Senior, depending on the candidate’s relevant experience.

Requirements

High school diploma or equivalent required for Level 1.
At least three years of patient pre-services coordinator or equivalent experience required for Level 1.
Proficiency with computer systems and Microsoft Office, including Word and Excel.
Knowledge of CPT coding and HCPS coding application.
Ability to communicate clearly verbally and use appropriate, correct terminology.
For the Senior level, at least three years of pre-services coordinator experience and two years of patient benefits experience are required.
For the Senior level, demonstrate knowledge and appropriate application of insurance coverage, benefits, and terminology.
Ability to meet the role’s physical demands, including sitting or standing, talking or hearing, handling and lifting patients, manual and finger dexterity, eye-hand coordination, extensive standing and walking, and occasionally lifting and carrying items up to 40 pounds.
Corrected vision and hearing within the normal range.
Ability to work at the employee site during regularly scheduled business hours.

Nice To Haves

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

Responsibilities

Before treatment, obtain insurance coverage and demographic information and educate patients about 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 when appropriate.
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 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 when patients should meet with staff.
Ensure the patient co-pay amount is correctly entered into the system or communicated so the front desk can collect it appropriately.
At each patient visit, verify and update patient demographics and insurance coverage in the computer system according to standard operating procedures.
Stay current on available financial assistance, develop professional relationships with assistance providers, and network with them to identify other assistance programs.
Protect patient records and comply with confidentiality requirements and applicable state and federal laws and guidelines, including HIPAA.
Maintain current manuals, logs, forms, and documentation.
Complete required e-learning courses within 90 days of occupying the position.
Perform additional duties as requested or assigned.