Patient Benefits Representative

Regional Cancer Care Associates; Chicago (IL); On-site; USD 30,000 - 36,000; Full time

Benefits offered by this job

401k

HSA

Medical

Dental

Vision

Perks Program (Vitality)

Job summary

Regional Cancer Care Associates is seeking a Patient Benefits Representative to educate patients on insurance coverage, verify benefits, and discuss financial responsibilities. You will manage referrals, obtain pre-authorizations, and help patients access financial aid to reduce out‑of‑pocket costs.

This full‑time role offers competitive benefits and an hourly rate of $22–$26. Typical duties include verifying insurance, coordinating referrals, assisting with financing options, and ensuring

Qualifications

• High school diploma or equivalent; 3 years patient pre-services coordinator experience.
• Proficient with computer systems and Microsoft Office (Word and Excel).
• Knowledge of CPT and HCPCS coding applications.
• Able to communicate clearly and use correct terminology.
• Complete required e-learning within 90 days of starting.
• Uses technical/functional knowledge and adapts to changing priorities.

Responsibilities

• Insurance Verification: verify active coverage, benefits and pre-authorization requirements.
• Referral Management: coordinate referrals and primary care authorizations timely.
• Financing Consults: discuss financial responsibilities and assist with aid programs to reduce costs.
• Educate patients pre-treatment on coverage, benefits, co-pays and deductibles.
• Assess ability to meet expenses and discuss payment arrangements; assist with forms.
• Complete Patient Cost Estimate forms and forward information to billing.
• Obtain pre-authorization or referral approval codes before treatment.
• Review balances and notify front desk; ensure accurate co-pay entry in system.

Skills

Verbal communication

Adaptability

Judgment/Decision making

Customer service

Education

High school diploma or equivalent

Tools

Microsoft Office (Word & Excel)

CPT coding

HCPCS coding

Job description

Overview

Patient Benefits Representative

Full-Time

Monday-Friday

Hourly Rate $22-$26

Benefits Include 401k, HSA, Medical, Dental, Vision, Perks Program (Vitality)

7447 W Talcott Ave, Chicago, IL

SCOPE:

Under general supervision, responsible for educating patients on insurance coverage and benefits. Assess patients’ financial ability; may educate patients 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

• -Insurance Verification: Verify active insurance coverage, benefits, and pre-authorization requirements prior to patient services.
• -Referral Management: Coordinate, track, and secure necessary referrals and primary care authorizations in a timely manner.
• -Financing Consults: Meet with patients to discuss their financial responsibilities, review outstanding insurance balances, and present flexible payment options or financial assistance programs. Identify underinsured or financially constrained patients and proactively research, apply for, and secure charitable grants, disease-specific foundations, and manufacturer copay assistance cards to lower their out-of-pocket costs.
• -Prior to a patient receiving treatment; obtaining 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 providers
• -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 systems according to Standard Operating Procedures (SOPs).
• -Stay current on available financial aid. Develop professional relationships with financial aid providers.
• -Networks with financial aid providers to obtain leads to other aid programs.
• -Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients' records.
• -Maintains updated manuals, logs, forms, and documentation.
• -Other duties as requested or assigned.

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.
• -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 in 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 efficiency.
• - 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.
• -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 in 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 efficiency.
• -Insurance Verification: Verify active insurance coverage, benefits, and pre-authorization requirements prior to patient services.
• -Referral Management: Coordinate, track, and secure necessary referrals and primary care authorizations in a timely manner.
• -Financing Consults: Meet with patients to discuss their financial responsibilities, review outstanding insurance balances, and present flexible payment options or financial assistance programs. Identify underinsured or financially constrained patients and proactively research, apply for, and secure charitable grants, disease-specific foundations, and manufacturer copay assistance cards to lower their out-of-pocket costs.
• -Prior to a patient receiving treatment; obtaining 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 providers
• -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 systems according to Standard Operating Procedures (SOPs).
• -Stay current on available financial aid. Develop professional relationships with financial aid providers.
• -Networks with financial aid providers to obtain leads to other aid programs.
• -Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients' records.
• -Maintains updated manuals, logs, forms, and documentation.
• -Other duties as requested or assigned.

Qualifications

• -Insurance Verification: Verify active insurance coverage, benefits, and pre-authorization requirements prior to patient services.
• -Referral Management: Coordinate, track, and secure necessary referrals and primary care authorizations in a timely manner.
• -Financing Consults: Meet with patients to discuss their financial responsibilities, review outstanding insurance balances, and present flexible payment options or financial assistance programs. Identify underinsured or financially constrained patients and proactively research, apply for, and secure charitable grants, disease-specific foundations, and manufacturer copay assistance cards to lower their out-of-pocket costs.
• -Prior to a patient receiving treatment; obtaining 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 providers
• -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 systems according to Standard Operating Procedures (SOPs).
• -Stay current on available financial aid. Develop professional relationships with financial aid providers.
• -Networks with financial aid providers to obtain leads to other aid programs.
• -Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients' records.
• -Maintains updated manuals, logs, forms, and documentation.
• -Other duties as requested or assigned.