Patient Benefit Rep

US Oncology Network-wide Career Opportunities; Panama City (FL); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

PTO

401k with match

Wellness program

Tuition reimbursement

Employee assistance

Job summary

Florida Cancer Affiliates in Panama City, FL is hiring a full-time Patient Benefit Rep. This role educates patients on insurance coverage and financial options, assesses ability to pay, and guides completion of forms.

You’ll work with clinical and billing teams to ensure timely pre-authorizations and accurate co-pays, while maintaining HIPAA compliance. Ideal candidates have a high school diploma, at least 3 years in patient pre-services coordination, and strong Microsoft Office skills.

Qualifications

• High school diploma or equivalent required.
• Minimum three (3) years patient pre-services coordinator or equivalent required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrate knowledge of CPT coding and HCPCS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.
• Must successfully complete required e-learning courses within 90 days of occupying position.

Responsibilities

• Before patient treatment, obtain insurance coverage information and demographics; educate patient on coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patient ability to meet expenses and discuss payment arrangements.
• Educate patients on financial assistance programs and identify sources; assist with forms.
• Complete Patient Cost Estimate form based on diagnosis, estimated coverage, and assistance; forward forms to billing.
• Obtain insurance pre-authorization or referral approval codes prior to treatment from Clinical Reviewer.
• Review patient account balance and notify front desk for appointment needs.
• Ensure correct co-pay entry in system to enable proper collection by front desk.
• Update demographics and insurance coverage at each patient visit per SOPs.
• Stay current on financial aide; build relationships with providers for leads to more aid programs.
• Maintain confidentiality per HIPAA and company policies.

Skills

Verbal communication

Professional terminology usage

Education

High school diploma or equivalent

Tools

Microsoft Office (Word & Excel)

Job description

Overview

Florida Cancer Affiliates in Panama City is hiring a

F/T, Patient Benefit Rep

Why work for us?

We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers.

SCOPE: Under general supervision, responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology*s Shared Values.

Responsibilities

ESSENTIAL RESPONSIBILITIES:

• Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients ability to meet expenses and discusses payment arrangements.
• May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms.
• Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form. Completes appropriate reimbursement and liability forms for patient*s review and signature. Forwards appropriate information and forms to billing office.
• Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with
• Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
• At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
• Stays current on available financial aide. Develops professional relationships with financial aide providers. Networks with financial aide providers to obtain leads to other aide programs.
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records.
• Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested. -
• Other duties as requested or assigned.

Qualifications

MINIMUM QUALIFICATIONS: High school diploma or equivalent required. Minimum three (3) years patient pre-services coordinator or equivalent required. Proficiency with computer systems and MicroSoft Office (Word and Excel) required. -Demonstrate knowledge of CPT coding and HCPS coding application. -Must be able to verbally communicate clearly and utilize the appropriate and correct terminology. -Must successfully complete required e-learning courses within 90 days of occupying position.

COMPETENCIES: -Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate. -Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. -Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. -Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes and service against those standards; manages quality; improves efficiencies.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

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 environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.