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About the Role
The Patient Benefits Representative will educate patients on insurance coverage and benefits, assess their financial ability, and may educate them on assistance programs. This role is crucial for updating and maintaining patient insurance information in the system and ensuring adherence to compliance programs and shared values.
Responsibilities
- Obtain insurance coverage information and demographics prior to patient treatment.
- Educate patients 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 assist with completing forms.
- Complete Patient Cost Estimate form based on diagnosis, estimated insurance coverage, and financial assistance.
- Complete reimbursement and liability forms for patient review and signature.
- Forward appropriate information and forms to the billing office.
- Obtain insurance pre-authorization or referral approval codes from Clinical Reviewer prior to each treatment.
- Review patient account balance and notify the front desk of patients requiring discussion.
- 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.
- Network with financial aid providers to identify leads for other aid programs.
- Adhere to confidentiality, state, federal, and HIPPA laws and guidelines.
- 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 the appropriate and correct terminology.
- Must successfully complete required e-learning courses within 90 days of occupying 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
- Quality Commitment
- CPT coding
- HCPS coding
- Microsoft Office (Word and Excel)
Location
- Austin, Texas
Work Type
- Full-time
- Onsite
Experience Level
- Level 1 or Sr. depending on candidate experience
Education Level
- High school diploma or equivalent
- Associates degree in Finance or Business (preferred for Sr. level)
Benefits
- Opportunities for learning and development
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 founders pioneered community-based cancer care to make the best available cancer care accessible to all communities.
- Texas Oncology uses leading-edge technology and research to deliver high-quality, evidence-based cancer care.
- The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system.