Patient Benefits Representative

Join the Texas Oncology team as a Patient Benefits Representative. This full?time position supports the Revenue Cycle Department at our 5206 Research Drive location in San Antonio, Texas. Typical work week is Monday through Friday, 9:30 a.m. 6:00 p.m.

As a part of the US Oncology Network, Texas Oncology delivers high?quality, evidence?based cancer care to patients close to home. Texas Oncology is the largest community?oncology provider in the country. The US Oncology Network is supported by McKesson Corporation to empower a sustainable community patient care system.

The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing patients financial ability, and assisting patients with financial aid programs. The representative updates and maintains patients new insurance eligibility, coverage, and benefits in the system and supports compliance with the US Oncology Compliance Program.

• Prior to a patient receiving treatment, obtains insurance coverage information and demographics and educates the patient on insurance coverage, benefits, co?pays, deductibles, and out?of?pocket expenses.
• Assesses patients ability to meet expenses, discusses payment arrangements, and educates patients on financial assistance programs. Completes Patient Cost Estimate form.
• Completes appropriate reimbursement and liability forms and forwards information to the billing office.
• Obtains insurance pre?authorization or referral approval codes prior to each treatment.
• Reviews patient account balance and notifies front desk of patients to meet with.
• Ensures that patient co?pay amount is correctly entered into the system.
• Verifies and updates demographics and insurance coverage at each patient visit according to SOPs.
• Stays current on available financial aid and develops professional relationships with financial aid providers.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
• Maintains updated manuals, logs, forms, and documentation and performs additional duties as requested.
  

Level 1

• High school diploma or equivalent.
• Minimum three (3) years patient pre?services coordinator or equivalent.
• Proficiency with computer systems and Microsoft Office (Word and Excel).
• Knowledge of CPT coding and HCPS coding application.
• Clear verbal communication using appropriate terminology.
• Completion of required e?learning courses within 90 days of occupying the position.
  

Level Sr (in addition to Level 1 requirements)

• Associates degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum three (3) years pre?services coordinator experience and two (2) years of patient benefits experience.
• Knowledge and appropriate application of insurance coverage benefits and terminology.
  

• Possesses up?to?date knowledge of the profession and industry and accesses expert resources when appropriate.
• Demonstrates adaptability, handles day?to?day challenges confidently, and remains flexible in the face of constraints.
• Uses sound judgment, makes timely, cost?effective decisions under uncertainty.
• Shows work commitment, sets high standards, pursues aggressive goals, and works efficiently.
• Commits to quality, emphasizes delivering quality products and services, and manages and improves efficiencies.
  

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is required to sit, stand, walk, talk, and hear during regularly scheduled business hours. The role requires full range of body motion, handling and lifting patients, manual and finger dexterity, eye?hand coordination, and standing and walking for extensive periods of time. The employee may occasionally lift and carry items weighing up to 40 lbs.