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 supports the Revenue Cycle Department at our 1901 S. 2nd Street clinic in McAllen, Texas. The typical work week is Monday through Friday, any eight hours between 7:30 a.m. and 5:00 p.m.

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

As part of 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 founders pioneered community‑based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people 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.

Under general supervision, the representative educates patients on insurance coverage and benefits, assesses patients’ financial ability, updates system records, supports US Oncology Compliance Program, and performs related responsibilities as described below.

• 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 patient ability to meet expenses and discuss payment arrangements. Educate patients on financial assistance programs and assist with completing forms. Complete Patient Cost Estimate form based on diagnosis, insurance coverage, and available assistance.
• Complete appropriate reimbursement and liability forms for patient review and signature, and forward information and forms to the billing office.
• Obtain pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
• Review patient account balance and notify front desk of patients required to meet with.
• Ensure that the patient co‑pay amount is correctly entered into the system (or conveyed) so that the front desk can collect appropriately.
• At each patient visit, verify and update demographics and insurance coverage in the computer system according to Standard Operating Procedures (SOPs).
• Stay current on available financial aid; develop professional relationships with financial aid providers; network with providers to obtain leads to other aid programs.
• Adhere to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
• Maintain updated manuals, logs, forms, and documentation; perform additional duties as requested.
• Other duties as requested or assigned.

• Level 1: 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, Excel) required. Demonstrate knowledge of CPT coding and HCPS coding application. Must communicate verbally clearly and use appropriate terminology. Must complete required e‑learning courses within 90 days of occupation.
• Level Sr (in addition to Level 1 requirements): Associate’s degree in finance or business, or four years of revenue cycle experience preferred. Minimum three years pre‑services coordinator experience and two years of patient benefits experience required. Must demonstrate knowledge and application of insurance coverage benefits and terminology.

• Uses…