Patient Benefits Representative

US Oncology • Santa Fe, NM

216d

About The Position

Nexus Health Multi Specialty, affiliated with McKesson Specialty Health and US Oncology, a leader in cancer care, is seeking an experienced Full Time Patient Benefits Representative to work in our brand new 3 level facility located in Santa Fe, NM. The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits, assessing patients' financial ability, and updating and maintaining existing patient insurance eligibility, coverage, and benefits in the system. This role supports and adheres to the US Oncology Compliance Program, including 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 appropriate terminology.
• Must successfully complete required e-learning courses within 90 days of occupying position.

Nice To Haves

• Associates degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
• Demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Responsibilities

• Obtain insurance coverage information and demographics prior to a patient receiving 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 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's review and signature.
• Obtain 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 the system.
• Verify and update demographics and insurance coverage in the computer system at each patient visit.
• Stay current on available financial aid and develop professional relationships with financial aid providers.
• Adhere to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
• Maintain updated manuals, logs, forms, and documentation.
• Perform additional duties as requested.

Benefits

• Medical
• Dental
• Vision
• Paid Holidays
• 401 K

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees