Patient Benefits Representative

Overview Texas Oncology is seeking a Patient Benefits Representative to support the Oncology Department at the 100 Bourland Road clinic in Keller, Texas. Responsibilities Prior to patient 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, discuss payment arrangements, educate on financial assistance programs, and identify sources; complete Patient Cost Estimate form as appropriate. 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 Clinical Reviewer prior to each treatment. Review patient account balance and notify front desk of patients to meet with. Ensure patient co‑pay amount is correctly entered into the system (or conveyed) so front desk can collect appropriately. Verify and update demographics and insurance coverage in the computer system at each patient visit according to SOPs. Stay current on available financial aid, develop professional relationships with aid providers, and network to obtain leads to other aide 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 Level 1 High school diploma or equivalent. Minimum 3 years as a patient pre‑services coordinator or equivalent. Proficiency with computer systems and Microsoft Office (Word & Excel). Knowledge of CPT and HCPCS coding applications. Ability to communicate verbally and use correct terminology. Successful completion of required e‑learning courses within 90 days of employment. Level Sr Associate’s degree in Finance, Business or four years of revenue cycle experience preferred. Minimum 3 years as a pre‑services coordinator and 2 years of patient benefits experience. Demonstrated knowledge and appropriate application of insurance coverage benefits and terminology. Competencies Technical and functional expertise: possess up‑to‑date knowledge of the profession and industry, regarded as a subject‑matter expert; access and use other resources when appropriate. Adaptability: handle daily work challenges confidently; adjust to multiple demands, shifting priorities, ambiguity, and rapid change; demonstrate resilience in the face of constraints. Sound judgment: make timely, cost‑effective decisions; make decisions under uncertainty. Work commitment: set high performance standards; pursue aggressive goals and work efficiently. Commitment to quality: deliver quality products/services; define standards; evaluate products, processes, and services; manage quality; improve efficiencies. Physical Demands The job requires regular presence at the employee site during business hours and requires sitting or standing, talking or hearing, full range of motion, handling and lifting patients, manual and finger dexterity, eye‑hand coordination, walking for extended periods, occasional lifting up to 40 lbs, and corrected vision and hearing. Work Environment The environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and conditions common to an oncology or hematology clinic. The job involves in‑person interaction with colleagues, management, and clients and may require minimal travel by automobile to office sites. #J-18808-Ljbffr US Oncology Inc.