Patient Benefits Specialist: Navigate Coverage for Patients

Talentify; Harlingen (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

The US Oncology Network, serving Texas Oncology at the Harlingen clinic, seeks a Patient Benefits Representative to educate patients about insurance coverage and benefits, assess financial ability, and support eligibility updates in the system. This role supports the Medical and Radiation Oncology Departments in a fast-paced clinic.

Level 1 or Senior depending on experience; requires organization, communication, and knowledge of insurance processes.

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 HCPCS 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; 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.
• 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.

Skills

Customer service

Insurance coverage

Computer skills

HIPAA knowledge

Education

High school diploma

Associate degree in Finance/Business (preferred)

Job description

The US Oncology Network, serving Texas Oncology at the Harlingen clinic, seeks a Patient Benefits Representative to educate patients about insurance coverage and benefits, assess financial ability, and support eligibility updates in the system. This role supports the Medical and Radiation Oncology Departments in a fast-paced clinic.

Level 1 or Senior depending on experience; requires organization, communication, and knowledge of insurance processes.