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 Radiation Oncology and Medical Oncology Departments at our 1700 W. Hwy 6 clinic in Waco, Texas. 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 mission is to use leading‑edge technology and research to deliver high‑quality, evidence‑based cancer care and 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.

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 existing patient eligibility, coverage, and benefits in the system. Supports and adheres to US Oncology Compliance Program, Code of Ethics, Business Standards, and Shared Values.

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, discuss payment arrangements, and educate patients on financial assistance programs as well as provide assistance with completing forms. Complete Patient Cost Estimate form based on diagnosis, coverage, and assistance.
• Complete appropriate reimbursement and liability forms for patient review and signature; forward information 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, allowing front desk to collect appropriately.
• At each patient visit, verify and update demographics and insurance coverage in computer system per SOPs.
• Stay current on available financial aide; develop relationships with financial aide providers; network for program leads.
• 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.
• 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 HCPS coding application.
• Must be able to verbally communicate clearly and utilize appropriate terminology.
• Must successfully complete required e‑learning courses within 90 days of occupying position.

Level Sr (in addition to level 1 requirements)

• 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 demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Competencies:

• Uses Technical and…