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 Surgical Oncology Department at our clinic in San Antonio, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. This position will be a Level 1 or Sr depending on relevant candidate experience. What does the Patient Benefits Representative do? The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits; assessing patients’ financial ability; and may educate patients on assistance programs. The role updates and maintains patient insurance eligibility, coverage, and benefits in the system and supports compliance with the US Oncology Compliance Program, Code of Ethics, Business Standards, and Shared Values. Responsibilities Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate the 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; assist forms and complete Patient Cost Estimate form. Complete reimbursement and liability forms for patient review and signature; forward information and forms to billing office. Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment. Review patient account balance and notify the front desk of patients who need to be met. Ensure patient co‑pay amount is correctly entered into the system, allowing front desk to collect appropriately. At each patient visit, verify and update demographics and insurance coverage in the system according to Standard Operating Procedures. Stay current on available financial aid; develop relationships with financial aid providers and 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. Other duties as requested or assigned. Qualifications The ideal candidate 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 experience required. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Demonstrated knowledge of CPT and HCPS coding application. Verbal communication clearly and use appropriate terminology. Successfully complete required e‑learning courses within 90 days of occupancy. Level Sr (in addition to Level 1 requirements) Associate’s degree in Finance or 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. Demonstrate knowledge and appropriate application of insurance coverage benefits and terminology. Competencies Uses Technical and Functional Experience: up‑to‑date knowledge of the profession and industry; regarded as an expert in the technical/functional area and uses expert resources when appropriate. Demonstrates Adaptability: handles day‑to‑day work challenges confidently; adapts to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints and adversity; demonstrates flexibility. Uses Sound Judgment: makes timely, cost‑effective and sound decisions; makes decisions under conditions of uncertainty. Shows Work Commitment: sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. Commits to Quality: emphasizes delivering quality products and/or services; defines standards, evaluates products, processes, and service against those standards; manages quality; improves efficiencies. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee must be present at the site during regularly scheduled business hours and regularly required to sit or stand, talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye‑hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. Work Environment The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic environment. Work involves in‑person interaction with co‑workers and management and/or clients. Minimal travel by automobile to office sites may be required. #J-18808-Ljbffr US Oncology Inc.