Patient Benefits Representative

Overview

Patient Benefits Representative – The US Oncology Network is looking for this role to join our team at Texas Oncology. This full‑time position will support the Oncology/Radiation Revenue Cycle Department at our 901 W. 38th Street clinic in Austin, Texas. Typical work week is Monday through Friday, 8:30 a.m. – 5:00 p.m.

Midtown is a close‑knit family that works very well together across all departments to ensure our patients are well cared for in a timely manner.

This position is a level 1 or Sr position depending on relevant candidate experience.

As part of The US Oncology Network, Texas Oncology delivers high‑quality, evidence‑based care to patients close to home.

• Prior to a patient receiving treatment, obtains insurance coverage information and demographics; educates 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 as well as identify sources and provide assistance with completing forms. Based on diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
• Completes appropriate reimbursement and liability forms for patient review and signature; forwards information and forms to billing office.
• Obtains, from Clinical Reviewer, insurance pre‑authorization or referral approval codes prior to each treatment.
• Reviews patient account balances and notifies front desk of patients to meet with.
• Ensures 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 SOPs.
• Stays current on available financial aide; develops professional relationships with financial aid providers and networks with providers to obtain leads to other aid programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
• Maintains updated manuals, logs, forms, and documentation; 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 required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrated 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.

• Associate’s 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.
• Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

• Uses technical and functional experience: possesses up‑to‑date knowledge of the profession and industry; is regarded as a subject‑matter expert in the technical/functional area; accesses and uses other expert resources when appropriate.
• Demonstrates adaptability: handles day‑to‑day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.
• Uses sound judgment: makes timely, cost‑effective and sound decisions; makes decisions under conditions of uncertainty.
• Shows work commitment: sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.
• Commits to quality: emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and services against those standards; manages quality; improves efficiencies.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential…