Patient Benefits Representative

City of Hope; Chesapeake (VA); On-site; USD 64,615,000 - 75,961,000; Full time

Benefits offered by this job

M/D/V

Life Ins.

401(k)

Job summary

Virginia Oncology Associates is seeking a Patient Benefits Representative for our Chesapeake location. This role focuses on collecting insurance details, explaining coverage and costs, and assisting patients with financial options.

The position requires a high school diploma, 3+ years in pre-services coordination, 2+ years in patient benefits, and proficiency with MS Office. Travel to clinics may be required; HIPAA compliance is essential.

Qualifications

• High school diploma or equivalent required.
• Minimum three (3) years pre-services coordinator experience required and two (2) years of patient benefits experience preferred.
• Proficiency with computer systems and Microsoft Office (Word and Excel).
• Demonstrated knowledge of CPT coding and HCPCS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate terminology.
• Must be willing to travel to all clinic locations as needed.

Responsibilities

• Obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients’ ability to meet expenses and discuss payment arrangements; inform on financial assistance programs.
• Complete Patient Cost Estimate form based on diagnosis and insurance coverage; forward forms to billing.
• Obtain insurance pre-authorization or referral approval codes before each treatment.
• Ensure patient co-pay is correctly entered into the system or conveyed.
• Verify and update demographics and insurance coverage per SOPs.
• Stay current on financial aide options and build relationships with financial aide providers.
• Maintain confidentiality and adhere to HIPAA laws; keep manuals and forms updated.

Skills

MS Office

CPT/HCPCS coding

Verbal communication

Travel flexibility

Education

High school diploma or equivalent

Job description

Overview

Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Patient Benefits Representative to support our Chesapeake location.

Employment Type: Full-Time, In-Person

Benefits: M/D/V, Life Ins., 401(k)

Compensation Range: $22.55/hr - $26.51/hr

Actual compensation will be determined based on job-related factors such as, relevant experience, education, certifications, licensure, and skills that align with the role.

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.
• Assesses 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 insurance pre-authorization or referral approval codes prior to each treatment.
• Ensures that patient co-pay amount is correctly entered into system (or conveyed)
• 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.

Qualifications

• High school diploma or equivalent required.
• Minimum three (3) years pre-services coordinator experience required and two (2) years of patient benefits experience preferred.
• Proficiency with computer systems and Microsoft Office (Word and Excel)
• Demonstrated knowledge of CPT coding and HCPS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.
• Must be willing to travel to all clinic locations as needed.

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

• High school diploma or equivalent required.
• Minimum three (3) years pre-services coordinator experience required and two (2) years of patient benefits experience preferred.
• Proficiency with computer systems and Microsoft Office (Word and Excel)
• Demonstrated knowledge of CPT coding and HCPS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.
• Must be willing to travel to all clinic locations as needed.

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

• 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.
• Assesses 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 insurance pre-authorization or referral approval codes prior to each treatment.
• Ensures that patient co-pay amount is correctly entered into system (or conveyed)
• 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.