Patient Benefits Representative

Overview

US Oncology Network is looking for a Patient Benefits Representative to join the team at Texas Oncology. This full‑time position supports the Revenue Cycle Department at the 1901 S. 2nd Street clinic in McAllen, Texas. Typical work week is Monday through Friday, any eight hours between 7:30a - 5:00p.

Note from Hiring Manager:
Our clinic offers a mission‑driven environment where patient‑centered care, clinical excellence, and operational integrity are genuinely valued. Team members benefit from collaborative leadership, clear expectations, and the opportunity to make a measurable impact on patient outcomes and clinic performance. This is an organization for professionals who want meaningful work, growth opportunities, and leadership that is engaged, supportive, and results‑oriented.

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

The Patient Benefits Representative, under general supervision, is responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Supports and adheres to the US Oncology Compliance Program, to include 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.
• Assess 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 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 to billing office.
• Responsible for obtaining, from Clinical Reviewer, insurance pre‑authorization or referral approval codes prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with.
• Ensure 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 aide. Develops professional relationships with financial aide providers. Networks with financial aide providers to obtain leads to other aide programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient’s records.
• Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
• Other duties as requested or assigned.

The ideal candidate for the Patient Benefits Representative will have the following background and experience:

• 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 HCPS 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 position.

Level Sr (in addition to level 1 requirements)

• Associates 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.

Competencies:

• Uses Technical and Functional
  
  Experience:
  
  Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate.
• D…