Patient Benefits Representative

Overview

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 and Radiation Oncology Departments at our 2000 Scenic Drive, Suite G002 clinic in Georgetown, Texas with possible travel to Round Rock North, Georgetown, and Harker Heights. Typical work week is Monday through Friday eight hours between 7:30a - 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 mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care. 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. The network is supported by Mc Kesson Corporation to empower a vibrant and sustainable community patient care delivery system.

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. Educate patients on financial assistance programs and identify sources; 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.
• Obtain, 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 SOPs.
• Stay current on available financial aide; develop professional relationships with financial aide providers; network with financial aide providers to obtain leads to other aide 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:

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 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 as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.
• Demonstrates Adaptability:
  Handles day-to-day work challenges confidently; adjusts to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the…