Patient Benefit Representative

Overview The Patient Benefits Representative will support the Medical Oncology Department at the Texas Oncology clinic located at 901 W. 38th Street in Austin, Texas. This full‑time position requires Monday–Friday work hours from 8:00 a.m. to 4:30 p.m. Depending on experience, the role may be Level1 or Senior. What Does the Patient Benefits Representative Do? The Patient Benefits Representative, under general supervision, educates patients on insurance coverage and benefits, assesses financial ability, and provides assistance through available programs. The role maintains accurate patient insurance and benefits information, adheres to compliance standards, and facilitates communication with billing and clinical teams. Responsibilities Prior to 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, offer financial assistance programs, and complete Patient Cost Estimate forms. Complete reimbursement and liability forms for patient review and signature; forward necessary information to the billing office. Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer before each treatment. Review patient account balances and inform front desk of patients needing to meet with the billing office. Ensure patient co‑pay amounts are correctly entered into the system so front desk collects appropriately. Verify and update demographics and insurance coverage at each visit according to Standard Operating Procedures. Stay current on available financial aid, establish relationships with providers, and network for additional aid programs. Adhere to confidentiality, state, federal, and HIPAA laws 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. Minimum of three (3) years as a patient pre‑services coordinator or equivalent. Proficiency with computer systems and Microsoft Office (Word and Excel). Knowledge of CPT coding and HCPCS coding application. Clear verbal communication skills and correct terminology usage. Completeness of required e‑learning courses within 90 days of occupation. LevelSr (in addition to Level1 requirements) Associate degree in Finance, Business, or four years of revenue cycle experience preferred. Minimum of three (3) years pre‑services coordinator experience and two (2) years of patient benefits experience. Demonstrated knowledge and application of insurance coverage benefits and terminology. Competencies Technical and Functional Experience: Up‑to‑date knowledge of the profession and industry; expert in the technical/functional area. Adaptability: Handles day‑to‑day work challenges confidently; adjusts to shifting priorities and rapid change. Sound Judgment: Makes timely, cost‑effective decisions under uncertainty. Work Commitment: Sets high performance standards; pursues vigorous goals efficiently. Commitment to Quality: Establishes standards, evaluates products/processes, and improves efficiencies. #J-18808-Ljbffr