Patient Benefits Representative

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 and Surgical Oncology Departments at our 100 NE Loop 410 location in San Antonio, Texas. Typical work week is Monday through Friday, 8:00 a.m. – 5:00 p.m. The position will be a Level 1 or Sr 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. The role includes assessing patient financial ability, educating patients on assistance programs, updating and maintaining patient insurance eligibility in the system, and supporting and adhering to the US Oncology Compliance Program. 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 and assist with completing forms. Complete Patient Cost Estimate form based on diagnosis, insurance coverage, and financial assistance. Complete appropriate reimbursement and liability forms for the patient’s review and signature; forward information and forms to billing office. Obtain insurance pre‑authorization or referral approval codes prior to each treatment from the Clinical Reviewer. Review patient account balance and notify front desk of patients to meet with. Ensure that the patient co‑pay amount is correctly entered into the system, allowing front desk to collect appropriately. At each patient visit, verify and update demographics and insurance coverage in the computer system according to SOPs. Stay current on available financial aid; develop professional relationships with financial aid providers; network to obtain 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. Qualifications Level 1 High school diploma or equivalent required. Minimum three (3) years as a patient pre‑services coordinator or equivalent required. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Knowledge of CPT coding and HCPCS coding application. Clear verbal communication and use of appropriate terminology. Complete required e‑learning courses within 90 days of occupation. Level Sr (in addition to Level 1 requirements) Associate’s degree in Finance, Business or four years of revenue cycle experience preferred. Minimum three (3) years as a pre‑services coordinator and two (2) years of patient benefits experience required. 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. Demonstrates Adaptability: Handles day‑to‑day challenges confidently; adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience and flexibility. Uses Sound Judgment: Makes timely, cost‑effective decisions under uncertainty. Shows Work Commitment: Sets high performance standards; pursues aggressive goals efficiently. Commits to Quality: Emphasizes delivering quality products or services; defines and evaluates standards; improves efficiencies. Physical Demands All duties are performed at the employee site during regularly scheduled business hours. Required to sit, stand, talk, and hear. Requires full range of body motion, handling and lifting patients, manual and finger dexterity, and eye‑hand coordination. Requires standing and walking for extensive periods; occasionally lifts and carries items weighing up to 40 lbs. Corrected vision and hearing to normal range. Reasonable accommodations may be made for individuals with disabilities. Work Environment May include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology clinic environment. Interaction with co‑workers, management, and clients occurs in person. Minimal travel by automobile to office sites may be required. #J-18808-Ljbffr Us Oncology Inc