Patient Benefits Representative

Overview

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full‑time position will support the Revenue Cycle Department at our 1609 Hospital Parkway clinic in Bedford, Texas. Typical work week is Monday through Friday, 8:30a – 5:00p.

Note from Hiring Manager:
Texas Oncology is a great company, and this is an awesome team!

This position will be a Level 1 or Sr role depending on relevant candidate experience.

As a part of The US Oncology Network, Texas Oncology delivers high‑quality, evidence‑based care to patients close to home. It is the largest community oncology provider in the country, with approximately 530 providers in 280+ sites across Texas. Our founders pioneered community‑based cancer care to make the best available cancer care accessible to all communities, allowing patients to fight cancer at home with the critical support of family and friends nearby.

Our mission is still the same today—at Texas Oncology, we use leading‑edge technology and research to deliver high‑quality, evidence‑based cancer care to help our patients achieve “More breakthroughs. More victories.”® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

The US Oncology Network is one of the nation’s largest networks of community‑based oncology physicians dedicated to advancing cancer care in America. It is supported by McKesson Corporation, focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits. The role assesses patients' financial ability, may educate patients on assistance programs, and updates and maintains existing patient insurance eligibility, coverage, and benefits in the system. The representative supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards and US Oncology’s Shared Values.

• 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.
• Assesses patients' ability to meet expenses and discusses payment arrangements; may educate patients on financial assistance programs and identify sources to assist 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.
• Obtains insurance pre‑authorization or referral approval codes from Clinical Reviewer prior to each treatment.
• Reviews patient account balance 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 Standard Operating Procedures (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 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 HCPCS coding application.
• Must be able to verbally communicate clearly and use the appropriate terminology.
• Must successfully complete required e‑learning courses…