Job Description

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 the Revenue Cycle Department at our 1957 Antilley Road clinic in Abilene, Texas. Typical work week is Monday through Friday, 8:30a - 5:00p.

This position will be a level 1 or Sr depending on relevant candidate experience.

Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas. Our mission is to use leading-edge technology and research to deliver high?quality, evidence?based cancer care and help our patients achieve More breakthroughs. More victories. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

The US Oncology Network is one of the nations largest networks of community?based oncology physicians dedicated to advancing cancer care in America. It is supported by McKesson Corporation , focused on empowering a vibrant and sustainable community patient care delivery system.

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

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits, assessing patient financial ability, and educating patients on assistance programs. They update and maintain patient new insurance eligibility, coverage, and benefits in the system, and support and adhere to the US Oncology Compliance Program, including the Code of Ethics, Business Standards, and US Oncologys Shared Values.

Responsibilities

• Prior to a patient receiving treatment, obtains insurance coverage information and demographics, and educates patient on insurance coverage, benefits, co?pays, deductibles, and out?of?pocket expenses.
• Assesses patients ability to meet expenses and discusses payment arrangements; may educate patients on financial assistance programs and assist with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
• Completes appropriate reimbursement and liability forms for patients review and signature, and forwards information and forms to the billing office.
• Obtains, from Clinical Reviewer, 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 system (or conveyed), allowing front desk to collect appropriately.
• At each patient visit, verifies and updates demographics and insurance coverage in the computer system according to Standard Operating Procedures (SOPs).
• Stays current on available financial aide, develops professional relationships with financial aide providers, and networks with financial aide providers to obtain leads to other aide programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient 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.
• 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 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 required.
• Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Competencies

• Uses Technical and Functional Experience: Possesses up?to?date knowledge of the profession and industry; is regarded a subject?matter 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 in 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 performance; pursues aggressive goals and works efficiently to achieve them.
• Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and services against those standards; manages quality; improves efficiencies.

Physical Demands

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and is regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye?hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

Work Environment

The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in?person interaction with co?workers and management and/or clients. Work may require minimal travel by automobile to office sites.

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