Patient Benefits Representative

Overview Join Our Team at Maryland Oncology Hematology! We’re looking for passionate and talented professionals to provide exceptional cancer care. With more than 15 locations across Maryland and DC, we offer a dynamic and supportive environment where you can grow and thrive. Explore opportunities with us and apply today. General pay scale for this position is $19.82 - $30.49 per hour. The actual hiring rate depends on factors such as prior work experience, education, job responsibilities, location, work performance, and other considerations. Scope With minimal supervision, the role is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and updating patient eligibility in the system while ensuring compliance with the US Oncology Compliance Program and related standards. Responsibilities Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate the patient on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses. Assess the patient’s ability to meet expenses and discuss payment arrangements. Educate patients on financial assistance programs, identify sources, and assist with completing forms. Complete the Patient Cost Estimate form based on diagnosis, estimated coverage, and assistance. Prepare reimbursement and liability forms for patient review and signature. Forward appropriate information and forms to the billing office. Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer before each treatment. Review patient account balances and notify the front desk of patients requiring follow‑up. Ensure the patient co‑pay amount is correctly entered into the system, allowing the 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. Stay current on available financial aid; develop professional relationships with providers; network to obtain leads for 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 High school diploma or equivalent required. Minimum three (3) years experience as a 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 use appropriate terminology. Must successfully complete required e‑learning courses within 90 days of occupying the position. Competencies Uses technical and functional expertise, staying up‑to‑date and accessing additional resources when appropriate. Demonstrates adaptability, handling daily work challenges confidently and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change. Uses sound judgment, making timely, cost‑effective decisions under conditions of uncertainty. Shows work commitment, setting high performance standards and pursuing aggressive goals efficiently. Commits to quality, defining standards and evaluating products, processes, and services against those standards to improve efficiencies. Physical Demands Requires presence at the employee site during regular business hours; requires sitting or standing, talking or hearing, handling and lifting patients, manual and finger dexterity, eye‑hand coordination, and standing and walking for extensive periods. Occasional lifting of items 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. Work involves in‑person interaction with co‑workers, management, and clients, and may require minimal automobile travel to office sites. #J-18808-Ljbffr