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 Blood and Marrow Transplant Department at our 7777 Forest Lane clinic in Dallas, Texas. Typical work week is Monday through Friday, 8:30 a.m. – 5:00 p.m.

Note from Hiring Manager
: BMT offers intellectual challenges and the existing team provides exceptional support to those willing to care for our transplant population.

This position is a Level 1 or Sr. 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. Texas Oncology is the largest community oncology provider in the country, operating approximately 530 providers in 280+ sites across Texas. The organization was founded to make high‑quality cancer care accessible to all communities, enabling patients to fight cancer at home with the support of family and friends nearby.

Our mission remains: “More breakthroughs. More victories.” Texas Oncology treats half of all Texans diagnosed with cancer annually.

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.

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and educating on assistance programs. They update and maintain patient insurance eligibility, coverage, and benefits in the system, and support compliance with the US Oncology Compliance Program.

• Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
• Assess patients’ ability to meet expenses and discuss payment arrangements; may educate on financial assistance programs and provide assistance with completing forms; based on diagnosis, estimated insurance coverage, and financial assistance, complete the Patient Cost Estimate form.
• 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 front desk of patients to meet with.
• Ensure that the patient co‑pay amount is correctly entered into the system (or conveyed), allowing front desk to collect appropriately.
• At each patient visit, verify and update demographics and insurance coverage in the computer system according to SOPs.
• Stay current on available financial aid; develop professional relationships with financial aid providers; network to obtain leads for other aid programs.
• Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient records.
• Maintain updated manuals, logs, forms, and documentation; perform 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.
• Demonstrate knowledge of CPT coding and HCPCS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate and correct 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 be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.