Patient Benefits Representative

US Oncology Inc.; Weslaco (TX); On-site; USD 36,000 - 55,000; Full time

Job summary

The US Oncology Network's Texas Oncology clinic in Weslaco, Texas is seeking a Patient Benefits Representative for the Revenue Cycle Patient Facing Department. This full-time role educates patients on insurance coverage, assists with financial options, and updates eligibility and benefits in the system.

Workweek is Monday through Friday, 8:00 am to 5:00 pm. The ideal candidate will have a high school diploma or equivalent and at least 3 years of related experience.

Qualifications

• High school diploma or equivalent.
• Minimum three years of experience in a related role preferred.

Responsibilities

• Educate patients on insurance coverage and benefits.
• Assess financial ability and discuss payment options or assistance programs.
• Update patient insurance eligibility, coverage and benefits in the system.
• Coordinate with billing to ensure accurate reimbursement and pre-authorizations.
• Maintain confidentiality and adhere to compliance standards.

Education

High school diploma or equivalent

3 years experience

Job description

Overview

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology. This full-time position will support the Revenue Cycle Patient Facing Department at our 1330 E. 6th Street clinic in Weslaco, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p.

This position will be a level 1 or Sr depending on relevant candidate experience.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.”® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

What does the Patient Benefits Representative do? (including, but not limited to):

Patient Benefits Representative, under general supervision is 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

• 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

The ideal candidate for the Patient Benefits Representative will have the following background and experience:

Level 1

• High school diploma or equivalent required.
• Minimum three (3) years