Patient Benefits Specialist - Financial & Insurance Support

Texas Oncology; Mount Pleasant (TX); On-site; USD 35,000 - 52,000; Full time

Job summary

The US Oncology Network, Texas Oncology site in Mt Pleasant, TX, seeks a Patient Benefits Representative to educate patients on insurance coverage, assess financial ability, and manage benefits in the system. This full-time role supports the Medical Oncology Department at 1612 Shadywood Lane.

The position may be Level 1 or Sr based on experience, with responsibilities including pre-authorizations, cost estimates, and collaboration with billing. A strong customer-service mindset is required.

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.

Responsibilities

• Prior to a patient receiving treatment; 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; educate patients on financial assistance programs and identify sources; complete Patient Cost Estimate form.
• Complete appropriate reimbursement and liability forms for patient’s review and signature; forward information and forms to billing office.
• Obtain, 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.
• At each patient visit, verify and update demographics and insurance coverage in system per SOPs.
• Stay current on available financial aide; develop relationships with providers; network to obtain leads to other aide programs.
• Adhere to confidentiality and HIPAA laws; manage patient records appropriately.
• Maintain manuals, logs, forms, and documentation; perform additional duties as requested.
• Other duties as requested or assigned.

Skills

Computer proficiency (MS Office)

Verbal communication

Insurance terminology

Customer service

Education

High school diploma or equivalent

Experience in patient pre-services coordination

Tools

CPT/HCPCS knowledge

Job description

The US Oncology Network, Texas Oncology site in Mt Pleasant, TX, seeks a Patient Benefits Representative to educate patients on insurance coverage, assess financial ability, and manage benefits in the system. This full-time role supports the Medical Oncology Department at 1612 Shadywood Lane.

The position may be Level 1 or Sr based on experience, with responsibilities including pre-authorizations, cost estimates, and collaboration with billing. A strong customer-service mindset is required.