Oncology Patient Benefits Lead - Access & Insurance Advocate

The US Oncology Network; Plano (TX); On-site; USD 28,000 - 41,000; Full time

Job summary

The US Oncology Network Texas Oncology is seeking a Patient Benefits Representative Lead to support the Radiation Oncology Department in Plano, TX. This full-time role focuses on assessing insurance coverage, guiding patients through benefits, and coordinating pre-authorizations for treatments.

The ideal candidate will have 3+ years in patient benefits, CPT/HCPCS knowledge, and strong communication skills to assist patients with financial options and ensuring accurate cost estimates.

Qualifications

• High school diploma or equivalent required.
• Associates degree in Finance/Business or 6 years revenue cycle experience preferred.
• Minimum 3 years of Patient Benefits experience required.
• Must demonstrate knowledge of CPT coding and HCPCS coding manuals.
• Must verbally communicate clearly and utilize correct terminology.
• Must demonstrate knowledge of insurance coverage benefits and terminology.

Responsibilities

• Before the patient's first appointment, obtains preliminary diagnosis, insurance coverage information and demographics; estimates coverage and completes patient cost estimate forms.
• During first appointment, educates patient on insurance coverage, pre-authorizations, benefits, co-pays, deductibles and out-of-pocket expenses; discusses payment arrangements and potential financial assistance programs.
• Obtains pre-authorization or referral approval codes from Clinical Reviewer prior to treatment.
• Keeps current knowledge of SOPs and supports onboarding of new staff.
• Ensures patient co-pay amounts are correctly entered and conveyed to front desk for collection.
• Reviews refund requests and adjustments; discusses delinquent payments with patients and payers.

Skills

CPT coding

Insurance terminology

Verbal communication

Adaptability

Teamwork

Education

High school diploma or equivalent

Associates degree in Finance/Business

Job description

The US Oncology Network Texas Oncology is seeking a Patient Benefits Representative Lead to support the Radiation Oncology Department in Plano, TX. This full-time role focuses on assessing insurance coverage, guiding patients through benefits, and coordinating pre-authorizations for treatments.

The ideal candidate will have 3+ years in patient benefits, CPT/HCPCS knowledge, and strong communication skills to assist patients with financial options and ensuring accurate cost estimates.