Patient Benefits Representative - MCD

The US Oncology Network•Dallas, TX

7d•Onsite

About The Position

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.
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.

Nice To Haves

Associates degree in Finance, Business or four years revenue cycle experience preferred.

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.