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 4708 Alliance Blvd #150, Plano, Texas. Typical work week is Monday through Friday, 8:00 a.m. – 5:00 p.m.

Note from Hiring Manager:
Texas Urology Specialists offers a supportive, patient-centered environment where Patient Benefit Coordinators help patients navigate their care with confidence. Team members are valued for their expertise, collaboration, and commitment to exceptional service, with opportunities to grow within a respected and stable specialty practice. Our focus on quality care, teamwork, and work–life balance makes this a rewarding place to build a long-term career.

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 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 annually.

Under general supervision, the Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits. Assess patients’ financial ability; may educate patients on assistance programs. Updates and maintains existing patient insurance eligibility, coverage, and benefits in the system. 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; obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patient’s ability to meet expenses and discuss payment arrangements. May educate patients on financial assistance programs and identify sources 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’s review and signature. Forward appropriate information and forms to billing office.
• Obtain insurance pre-authorization or referral approval codes from Clinical Reviewer 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 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 with financial aid providers to obtain leads to other aid programs.
• Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regard to 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 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 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…