Patient Benefits Representative

The US Oncology Network•Richardson, TX

1d•Onsite

About The Position

The US Oncology Network is looking for a Patient Benefits Representative to join their team at Texas Oncology. This full-time position will support the Revenue Cycle Department at their Richardson, Texas location. The role involves educating patients on insurance coverage and benefits, assessing their financial ability, and updating insurance information in the system. The position adheres to the US Oncology Compliance Program, Code of Ethics, Business Standards, and Shared Values.

Requirements

Obtain insurance coverage information and demographics prior to patient treatment.
Educate 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.

Responsibilities

Obtain insurance coverage information and demographics prior to patient treatment.
Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
Assess patients' ability to meet expenses and discuss payment arrangements.
Educate patients on financial assistance programs, identify sources, and assist with completing forms.
Complete Patient Cost Estimate form 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 prior to each treatment.
Review patient account balance and notify the front desk of patients needing to meet.
Ensure patient co-pay amount is correctly entered into the system for collection.
Verify and update demographics and insurance coverage in the computer system at each patient visit according to SOPs.
Stay current on available financial aid.
Develop professional relationships with financial aid providers.
Network with financial aid providers to obtain leads to other aid programs.
Adhere to confidentiality, state, federal, and HIPPA laws and guidelines regarding patient records.
Maintain updated manuals, logs, forms, and documentation.
Perform additional duties as requested or assigned.