Patient Benefits Representative

The US Oncology Network; Virginia Beach (VA); On-site; USD 31,000 - 37,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life Insurance

401(k)

Job summary

Virginia Oncology Associates in Virginia Beach seeks a dedicated Patient Benefits Representative to support operations at our clinic. This full-time, in-person position focuses on gathering insurance details, educating patients on coverage, and coordinating financial assistance as needed.

You will determine patient eligibility, obtain pre-authorizations, and ensure accurate data entry in systems, while upholding privacy and HIPAA regulations. Local travel between sites may occur.

Qualifications

• High school diploma or equivalent required.
• Minimum three years pre-services coordinator experience required.
• Two years patient benefits experience preferred.
• Proficiency with CPT and HCPCS coding.
• Proficiency with Microsoft Office (Word and Excel).

Responsibilities

• Obtain insurance coverage information and patient demographics before treatment.
• Educate patients on benefits, co-pays, deductibles, and out-of-pocket costs.
• Assess affordability and discuss payment arrangements; assist with financial aid forms.
• Prepare patient cost estimates and forward forms to billing.
• Obtain insurance pre-authorization or referral codes prior to treatment.
• Verify and update demographics and coverage in the system.
• Stay current on financial aid options and build relationships with providers.
• Adhere to confidentiality and HIPAA; follow SOPs.
• Maintain manuals, logs, forms, and documentation; perform other duties.

Skills

Microsoft Office

CPT coding

HCPCS coding

Verbal communication

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 Virginia Beach location.

Employment Type: Full-Time, I n-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 locationsas 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