Patient Benefit Representative

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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 Oncology Department at our 1200 Brooklyn Avenue #115 clinic in San Antonio, Texas. Typical work week is Monday through Friday, 8:30a – 5:00p.

What does the Patient Benefits Representative do?

Under general supervision, the Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing financial ability, educating on assistance programs, updating new insurance eligibility, and supporting compliance programs.

Responsibilities

• Obtain insurance coverage information and demographics; educate patients on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
• Assess patients’ ability to meet expenses and discuss payment arrangements; educate on financial assistance programs and complete Patient Cost Estimate form.
• Complete appropriate reimbursement and liability forms for patient signature; forward forms to billing office.
• Obtain pre‑authorization or referral approval codes before each treatment.
• Review patient account balance and notify front desk as required.
• Enter patient co‑pay amount correctly to allow front desk collection.
• Verify and update demographics and insurance coverage in the computer system at each visit.
• Stay current on available financial aide; develop relationships with financial aid providers; network 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.

Qualifications

• High school diploma or equivalent.
• Minimum three (3) years patient pre‑services coordinator or equivalent.
• Proficiency with Microsoft Word and Excel.
• Knowledge of CPT coding and HCPCS coding application.
• Clear verbal communication skills.
• Complete required e‑learning courses within 90 days of position start.

Level Sr (additional to Level 1 requirements)

• Associates degree in Finance, Business or preferred four‑year revenue cycle experience.
• Minimum three (3) years pre‑services coordinator experience and two (2) years patient benefits experience.
• Demonstrate knowledge and application of insurance coverage benefits and terminology.

Competencies

• Uses technical and functional experience; accesses expert resources when appropriate.
• Demonstrates adaptability; handles day‑to‑day work challenges confidently and adjusts to multiple demands.
• Uses sound judgment; makes timely, cost‑effective decisions under uncertainty.
• Shows work commitment; pursues aggressive goals and works efficiently.
• Commits to quality; emphasizes delivering quality products and services; manages quality improvements.

Physical Demands

Requires full range of body motion, handling and lifting patients, manual dexterity, and eye‑hand coordination. Standing and walking for extensive periods; occasionally lifts items up to 40 lbs. Corrected vision and hearing to normal range.

Work Environment

May include exposure to communicable diseases, toxic substances, and other conditions common to an oncology/hematology clinic. Work involves in‑person interaction with coworkers and management and may require minimal travel by automobile to office sites.