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Patient Benefits Representative

3 months ago

Nacogdoches, United States Texas Oncology Full time

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 our **Nacogdoches **clinic at 4800 NE Stallings Dr.

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.

**The **US Oncology Network** is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. **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.

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

The 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**:
**The essential duties and responsibilities (including, but not limited to)**
- 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:
**Level 1**
- 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.
- 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.

**Level Sr (in addition to level 1 requirements)**
- Associates degree in Finance, Business or four years revenue cycle experience preferred.

**Competencies**:

- Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate.
- Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.
- Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.
- Shows Work Commitment: Sets high standards of pe