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 Oncology Department at our 6520 Horizon Circle clinic in Waco, Texas with possible travel to a sister site in Waco. Typical work week is Monday through Friday, 8:30a - 5:00p. 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 founders pioneered community-based cancer care, making the best available cancer care accessible to all communities. Our mission remains 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.

The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America.
The US Oncology Network is supported by Mc Kesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

The essential duties and responsibilities (including, but not limited to):

• 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 patients’ ability to meet expenses and discuss payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Based on diagnosis, estimated insurance coverage, and financial assistance, complete Patient Cost Estimate form.
• Complete appropriate reimbursement and liability forms for patient’s review and signature. Forward 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, verify and update demographics and insurance coverage in computer system according to Standard Operating Procedures (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 regards to patient records.
• Maintain updated manuals, logs, forms, and documentation. Perform 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 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.

• 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.

• Uses Technical and Functional
  
  Experience:
  
  Possesses up to…