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 Urology Department at our 5450 Clearfork Main Street Suite 420 clinic in Fort Worth, Texas. Typical work week is Monday through Friday, 8:00a–5:00p. This position will be a level 1 or Sr 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.
Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas. Our mission is to make cancer care accessible and to help patients achieve “More breakthroughs. More victories.”® in their fight against cancer.

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and maintaining accurate records in the system.

• 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.
• Assess patients ability to meet expenses and discusses payment arrangements; may educate patients on financial assistance programs and assist with completing forms; completes Patient Cost Estimate form based on diagnosis, estimated coverage, and assistance.
• Completes appropriate reimbursement and liability forms for patient’s 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 balance and notifies front desk of patients to meet with.
• Ensures that patient co‑pay amount is correctly entered into system, allowing front desk to collect appropriately.
• At each patient visit, verifies and updates demographics and insurance coverage in the computer system according to SOPs.
• Stays current on available financial aide; develops professional relationships with financial aide providers; networks to obtain leads to other aide programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding 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.
• Demonstrate knowledge of CPT coding and HCPCS 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 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 specialist; accesses and uses 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; evaluates products, processes,…