Patient Benefit Specialist

Virginia Cancer Specialists; Centreville (VA); On-site; USD 42,000 - 64,000; Full time

Job summary

Virginia Cancer Specialists in Fairfax is seeking an experienced full-time Patient Benefit Specialist to verify insurance, assess patient financial requirements, and counsel patients on benefits and co-payments. The role includes obtaining pre-authorizations, maintaining patient demographics, and supporting compliance with the US Oncology standards to ensure smooth front-office operations.

Join a team committed to helping patients navigate coverage and cost, with comprehensive benefits and a

Qualifications

• High school diploma or equivalent.
• At least 3 years of medical business office experience with insurance procedures and patient interaction.

Responsibilities

• Obtains and maintains accurate insurance, demographic, and eligibility information.
• Performs insurance verification for all payers and obtains initial and subsequent pre-authorizations.
• Re-verifies benefits and obtains required authorizations after treatment plan discussion.
• Uses patient reimbursement summaries and obtains approvals as needed.
• Performs financial counseling for all patients, discusses financial obligations and payment arrangements.
• Documents counseling process and forwards to Billing Office.
• Assists patients in obtaining financial assistance and outside support services.
• Collects co-pays, deductibles, and other out-of-pocket amounts at visit.
• Maintains manuals, logs, and required documentation.
• Protects patient confidentiality and adheres to policies and procedures.

Skills

Insurance verification

Pre-authorization

Financial counseling

Patient interaction

Data entry

Education

High school diploma or equivalent

Tools

Billing software

EMR system

Job description

Overview

Are you looking for a career and not just a job in the Medical field?Virginia Cancer Specialists, affiliated with McKesson Specialty Health and US Oncology, a leader in cancer care, is seeking an experienced full time Patient Benefit Specialist for our Fairfax office. GREAT BENEFITS INCLUDE: Medical, Dental, Vision, Paid Holidays, and 401(k).

SCOPE: Under general supervision, is responsible for insurance verification and eligibility, assessment of patient financial requirements, counseling patients on insurance benefits and co-payments. Obtains pre-authorization of services. Obtains and maintains accurate patient demographics. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensures all insurance, demographic, and eligibility information is obtained and entered into the system in an accurate manner.
• Performs insurance verification process on all third party payers. Obtains initial and subsequent pre-authorization for services and surgeries.
• Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment. Ensures appropriate signatures are obtained on all necessary forms.
• Utilizes the Summary of Patient Reimbursement and Liability form and obtains appropriate approvals as required.
• Performs financial counseling process on all patients prior to treatment, which includes patient financial obligations, billing practices and establishing payment arrangements.
• Documents financial counseling process and forwards to Billing Office.
• Assists patients in obtaining financial assistance (i.e. Medicaid, drug replacement), outside assistance (i.e. transportation or other community services), and all appropriate forms filled out.
• Collects co-pays, deductible and other out of pocket amounts at time of visit.
• Assists in maintaining manuals, logs and other required documentation as required.
• Demonstrates an understanding for patient confidentiality to protect the patient and the clinic/corporation.
• Follows policies and procedures to contribute to the efficiency of the front office. Covers for and assists with other front office functions as requested.

Qualifications

MINIMUM QUALIFICATIONS: High school diploma or equivalent required. Minimum three years of medical business office experience with insurance procedures and patient interaction.

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. Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, copier and other office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for prolonged periods of time.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent interaction with staff, patients and the public.

Join us at Virginia Cancer Specialists, where meeting and exceeding the needs of our patients is our primary goal! The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.