Patient Services Representative

Patient Services Representative

The US Oncology Network/Texas Breast Specialists is looking for a Patient Services Representative to join our Breast Surgery team! This position will support the South Austin location (4101 James Casey St #340 Austin, Texas 78745). Typical work week is Monday through Friday, 8 am - 4:30pm with no weekends or major holidays!

This position can be a level 2 or Sr based on 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 still 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.

What does the Patient Services Representative do?

Under direct supervision, performs general business office functions that may include some or all of the following: billing and claim submissions; charge capture and payment posting; insurance verification and eligibility; obtaining pre-authorization; counseling patients and families on insurance and payment issues; and account follow-up and payment resolution. As necessary, assists patients and families with obtaining community resources including, but not limited to, housing, transportation, and financial support. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Responsibilities

• Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner. Registers patients in the system as necessary.
• Collects and reviews all patient insurance information and completes insurance forms. Collects co-pays, deductibles and other out of pocket amounts at the time of visit.
• Confirms patient insurance verification and eligibility. Obtains pre-authorization of services and/or referrals. Assesses patient financial requirements and advises patients and families on insurance benefits, co-pays and financial obligations.
• Posts line items and adjustments to patient accounts. Balances receipts, reconciles daily work batches and prepares audit trail. Prepares deposits for bank as needed.
• Reviews Explanation of Benefits (EOB) for consistency.
• Submits files and processes all claims for payment. Researches and resolves claim delay issues.
• Resolves patient questions and complaints regarding insurance billing and adjusts accounts as necessary. Resubmits claims and processes all insurance/patient correspondence. Provides all documentation to expedite payment.
• Follows-up on assigned accounts. Uses collection techniques to keep accounts current including monitoring for delinquent payments.
• Sets-up financial arrangements with patients as necessary.
• As necessary, assists patients with researching and obtaining community resources including housing, transportation, drugs and pharmaceutical supplies, and financial resources.

Qualifications

The ideal candidate for the Patient Services Representative will have the following background and experience:

Level 2

• High School Diploma or equivalent required.
• Minimum 3 to 5 years medical business office experience.

Level Sr (in addition to level 1 and 2 requirements)

• Minimum five years medical business office experience.

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 is regularly required to sit and use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires frequent interaction with patients and staff.