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 Medical Oncology Department at our 2021 N. MacArthur clinic in Irving, Texas. Typical work week is Monday through Friday, 8:30a - 5:00p. 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 founders pioneered community-based cancer care, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is to provide leading edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve more breakthroughs and more victories. This position will be a Level 1 or Sr level 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. They update and maintain existing patient insurance eligibility, coverage, and benefits in the system and support compliance with the US Oncology Compliance Program and Code of Ethics. Responsibilities Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patients on 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 assist in completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, complete Patient Cost Estimate form. Complete reimbursement and liability forms for patient review and signature. Forward appropriate 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 front desk of patients to meet with. Ensure that patient co-pay amount is correctly entered into the system (or conveyed), allowing front desk to collect appropriately. At each patient visit, verify and update demographics and insurance coverage in the computer system according to Standard Operating Procedures (SOPs). Stay current on available financial aid. Develop professional relationships with financial aid providers and network to obtain leads for other aid programs. Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patients' records. Maintain updated manuals, logs, forms, and documentation. Perform additional duties as requested. Other duties as requested or assigned. Qualifications The ideal candidate for the Patient Benefits Representative will have the following background and experience: Level 1 High school diploma or equivalent required. Minimum 3 years patient pre-services coordinator or equivalent experience 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 use appropriate terminology. Must successfully complete required e-learning courses within 90 days of starting the position. Level Sr (in addition to Level 1 requirements) Associate's degree in Finance, Business or four years of revenue cycle experience preferred. Minimum 3 years pre-services coordinator experience and 2 years of patient benefits experience required. Must demonstrate knowledge and appropriate application of insurance coverage benefits and terminology. Competencies Uses Technical and Functional Experience: Possesses up-to-date knowledge of the profession and industry and is regarded as an expert in the technical/functional area. Demonstrates Adaptability: Handles day-to-day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints, frustrations, or 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 the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and services 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 is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and 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 will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites. #J-18808-Ljbffr