Patient Benefits Representative Garland

Patient Benefits Representative Full‑time position at Texas Oncology, 7150 N. President George Bush Highway Suite 200, Garland, TX. Typical work week Monday through Friday, 8:00a‑5:00p. Level: Level 1 or Senior, depending on experience. Job Summary The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and guiding patients through financial assistance programs. The role includes maintaining eligibility records, ensuring accurate billing and pre‑authorization, and adhering to privacy and compliance standards. Responsibilities Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on coverage, co‑pays, deductibles and out‑of‑pocket expenses. Assess patient ability to meet expenses and discuss payment arrangements; educate on financial assistance programs and assist completion of forms; complete Patient Cost Estimate form based on diagnosis, coverage and assistance. Complete reimbursement and liability forms for patient review and signature; forward appropriate information and forms to billing office. Obtain 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 the patient co‑pay amount is correctly entered or conveyed to allow front desk to collect appropriately. At each patient visit, verify and update demographics and insurance coverage in the computer system per SOPs. Stay current on available financial aid; develop professional relationships and network with aid providers to obtain leads on other 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 required. Minimum three years experience as a patient pre‑services coordinator or equivalent. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Knowledge of CPT coding and HCPS coding application. Clear verbal communication and correct terminology usage. Successful completion of required e‑learning courses within 90 days of appointment. Level Sr (in addition to Level 1 requirements) Associate degree in Finance, Business or four years revenue cycle experience preferred. Minimum three years pre‑services coordinator experience and two years of patient benefits experience required. Demonstrated knowledge and application of insurance coverage benefits and terminology. Competencies Uses technical and functional experience; stays current and consults experts when appropriate. Demonstrates adaptability to changing demands, ambiguity and rapid change. Applies sound judgment to make timely, cost‑effective decisions under uncertainty. Displays work commitment, setting high performance standards and pursuing goals efficiently. Commits to quality, defining standards and evaluating products, processes and services against them. Physical Demands Employees must be present during business hours and may be required to sit, stand, talk and hear. The role requires full range of body motion including handling and lifting patients, manual and finger dexterity, eye‑hand coordination, standing and walking for extended periods, and occasionally lifting/carrying items up to 40 lbs. Corrected vision and hearing to normal range is required. 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 will involve in‑person interaction with co‑workers, management and clients; minimal travel by automobile to office sites may be required. #J-18808-Ljbffr US Oncology Inc.