Patient Benefits Representative

Patient Benefits Representative – a full‑time position at Texas Oncology’s revenue cycle department in Amarillo, Texas. Responsibilities include educating patients about insurance coverage, assessing financial ability, and coordinating payments. The role is offered at Level 1 or Level Sr, following a Monday‑to‑Friday 8:00 a.m.–5:00 p.m. schedule.

• Prior to a patient receiving treatment, obtains insurance coverage information and demographics and educates the patient on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
• Assesses patients’ ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs, identify sources, and help complete forms. Based on diagnosis, estimated coverage, and financial assistance, completes a Patient Cost Estimate form.
• Completes appropriate reimbursement and liability forms for patient review and signature. Forwards appropriate information and forms to the billing office.
• Obtains insurance pre‑authorization or referral approval codes prior to each treatment.
• Reviews patient account balance and notifies the front desk of patients to meet with.
• Ensures the patient co‑pay amount is correctly entered into the system (or conveyed), allowing the front desk to collect appropriately.
• At each patient visit verifies and updates demographics and insurance coverage in the computer system per SOPs.
• Stays current on available financial aid, develops professional relationships with financial aid providers, and networks with them to obtain leads to other aid programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
• Maintains updated manuals, logs, forms, and documentation, and performs additional duties as requested.
• Other duties as requested or assigned.

• High‑school diploma or equivalent required.
• Minimum three (3) years patient pre‑services coordinator or equivalent experience required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrated knowledge of CPT and HCPCS coding application.
• Must be able to verbally communicate clearly and use appropriate terminology.
• Must successfully complete required e‑learning courses within 90 days of occupying the position.

• Associate’s degree in Finance, Business, or four years of revenue cycle experience preferred.
• Minimum three (3) years pre‑services coordinator experience and two (2) years of patient benefits experience required.
• Must demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

• Uses technical and functional knowledge; regarded as an expert and accesses other expert resources when appropriate.
• Demonstrates adaptability; handles day‑to‑day work challenges, adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience in the face of constraints and frustrations.
• Uses sound judgment; makes timely, cost‑effective, and sound decisions under uncertainty.
• Shows work commitment; sets high standards of performance and works efficiently to achieve goals.
• Commits to quality; emphasizes delivery of quality products and services, defines standards, evaluates against them, manages quality, and improves efficiencies.

The physical demands described are representative of those that must be met to perform the essential functions of this job. The employee may be required to sit or stand and to talk or hear for regularly scheduled business hours. Full range of body motion, including handling and lifting patients, manual and finger dexterity, eye‑hand coordination, and standing/walking for extended periods. Occasional lifting of items up to 40 lbs.

Corrected vision and hearing to normal range. Reasonable accommodations may be made to assist individuals with disabilities.

The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology clinic. Work will involve in‑person interaction with co‑workers and management or clients and may require minimal travel by automobile to office sites.