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 Oncology Department at our 100 Bourland Road clinic in Keller, Texas. The typical work week is Monday through Friday, 7:30 a.m. to 4:00 p.m. The role may be Level1 or Senior depending on 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 financial ability, updating insurance eligibility and benefits in the system, and ensuring compliance with US Oncology standards. Responsibilities 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 patient ability to meet expenses, discuss payment arrangements, and educate patients on financial assistance programs; complete Patient Cost Estimate form based on diagnosis, insurance coverage, and assistance. Complete appropriate reimbursement and liability forms for patient review and signature; forward information to the billing office. Obtain, from the 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 the system (or conveyed), allowing front desk to collect appropriately. Verify and update demographics and insurance coverage in the computer system at each patient visit per SOPs. Stay current on available financial aid, develop professional relationships with aid providers, and network with providers for 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 Level1 High school diploma or equivalent required. Minimum three (3) years of 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 utilize appropriate terminology. Must successfully complete required e‑learning courses within 90 days of occupation. LevelSr (in addition to Level1 requirements) Associate’s degree in Finance, Business, or four years of revenue cycle experience preferred. Minimum three (3) years of pre‑services coordinator experience and two (2) years of patient benefits experience required. Must be able to 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; regarded as a subject‑matter expert; accesses and uses other expert resources when appropriate. 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 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 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 lb. Requires corrected vision and hearing within 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