Patient Benefit Representative

Patient Benefit Representative – The US Oncology Network Overview

Full‑time position that will support the Oncology Department at our 1200 Brooklyn Avenue #115 clinic in San Antonio, Texas. Typical work week is Monday through Friday, 8:30 a.m. – 5:00 p.m. Note from Hiring Manager:
The downtown Texas Oncology facility operates collaboratively as a team in a very positive environment. 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 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.

• 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 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 forms 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 regards to patient
  * s 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 the appropriate and correct 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 be able to 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 a san expert in the technical/functional area; accesses and uses other 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…