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About the Role
The Patient Benefits Representative plays a key role in supporting patients throughout their care journey by assisting with insurance benefits, authorizations, and financial responsibilities. This role requires clear communication, attention to detail, and compassionate support to create a smooth and positive experience for patients and their families.
Responsibilities
- Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses prior to treatment.
- Assess patients' ability to meet expenses and discuss payment arrangements.
- Educate patients on financial assistance programs and assist with completing forms.
- Complete Patient Cost Estimate forms based upon diagnosis, estimated insurance coverage, and financial assistance.
- Complete reimbursement and liability forms for patient review and signature, and forward to the billing office.
- Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer before each treatment.
- Review patient account balance and notify the front desk of patients requiring a meeting.
- Ensure correct entry of patient co-pay amounts into the system for accurate collection.
- Verify and update patient demographics and insurance coverage in the computer system at each visit.
- Stay current on available financial aid programs and develop professional relationships with financial aid providers.
- Adhere to confidentiality, state, federal, and HIPPA laws and guidelines regarding patient records.
- Maintain updated manuals, logs, forms, and documentation.
- Perform additional duties as requested or assigned.
Requirements
- 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 appropriate and correct terminology.
- Must successfully complete required e-learning courses within 90 days of occupying the position.
- Associates degree in Finance, Business or four years revenue cycle experience preferred (for Sr. level).
- Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required (for Sr. level).
- Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology (for Sr. level).
Skills
- Technical and Functional Experience
- Adaptability
- Sound Judgment
- Work Commitment
- Commitment to Quality
Location
- Austin, Texas
Work Type
- Full-time
- Onsite
Experience Level
- Level 1 or Sr. depending on experience
Education Level
- High school diploma or equivalent
- Associates degree in Finance, Business (preferred for Sr. level)
About the Company
- The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America.
- Texas Oncology delivers high-quality, evidence-based care to patients close to home.
- Texas Oncology is the largest community oncology provider in the country, with approximately 530 providers in 280+ sites across Texas.
- Texas Oncology's mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help patients achieve ‘More breakthroughs. More victories.’ ® in their fight against cancer.
- The 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.