Patient Benefits Representative Sr

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 Medical Oncology/Revenue Cycle Department at our 4461 Coit Road, #100 clinic in Frisco, Texas, with possible travel to help cover sister site as needed. Typical work week is Monday through Friday, 8:30a - 5:00p.

Note from Hiring Manager:
Our Frisco/Frisco West market is growing rapidly!

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, helping patients achieve “More breakthroughs. More victories.”®

in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer annually.

The US Oncology Network is one of the nation’s largest networks of community‑based oncology physicians dedicated to advancing cancer care. It is supported by McKesson Corporation, focused on empowering a vibrant and sustainable community patient care delivery system.

What does the Patient Benefits Representative do? (including, but not limited to)

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and updating and maintaining patient insurance eligibility, coverage, and benefits in the system. The role supports and adheres to the US Oncology Compliance Program, including the Code of Ethics, Business Standards, and US Oncology’s Shared Values.

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

• 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.
• Assesses patients’ ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Completes Patient Cost Estimate form based upon diagnosis, estimated insurance coverage, and financial assistance.
• Completes appropriate reimbursement and liability forms for patient’s review and signature. Forwards appropriate information and forms to billing office.
• Obtains insurance pre‑authorization or referral approval codes prior to each treatment from Clinical Reviewer.
• Reviews patient account balance and notifies front desk of patients to meet with.
• Ensures 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 aid. Develops professional relationships with financial aid providers. Networks with providers to obtain leads to other aid programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient records.
• Maintains updated manuals, logs, forms, and documentation. Performs 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 HCPS 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…