The US Oncology Network
Patient Benefits Representative
The US Oncology Network, Bedford, Virginia, United States, 24523
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 1609 Hospital Parkway clinic in Bedford, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. The role may be at Level 1 or Sr depending on candidate experience.
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, with approximately 530 providers in 280+ sites across Texas. Our mission is to deliver high-quality, evidence-based cancer care to help patients achieve more breakthroughs and victories in their fight against cancer.
The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians, supported by McKesson Corporation to empower 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. Assess patients’ financial ability; may educate patients on assistance programs. Updates and maintains existing patient insurance eligibility, coverage, and benefits in the system. Supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards, and US Oncology’s Shared Values.
Responsibilities
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.
Assesses 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 on 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.
Obtains insurance pre-authorization or referral approval codes from Clinical Reviewer 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 (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 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 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 The ideal candidate for the Patient Benefits Representative will have the following background and experience:
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.
Clear verbal communication and appropriate terminology usage.
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.
Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
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; seeks expert resources when appropriate.
Demonstrates Adaptability: Handles day-to-day work challenges, adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience.
Uses Sound Judgment: Makes timely, cost-effective, and sound decisions under uncertainty.
Shows Work Commitment: Sets high standards of performance and pursues aggressive goals.
Commits to Quality: Delivers quality services; defines standards and evaluates against them; strives to improve 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. The role requires being present at the site during regularly scheduled hours; ability to sit or stand and talk or hear; full range of body motion; occasional lifting up to 40 lbs. 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. In-person interaction with co-workers, management, and/or clients. May require minimal travel by automobile to office sites.
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Patient Benefits Representative
to join our team at
Texas Oncology . This full-time position will support the Revenue Cycle Department at our 1609 Hospital Parkway clinic in Bedford, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. The role may be at Level 1 or Sr depending on candidate experience.
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, with approximately 530 providers in 280+ sites across Texas. Our mission is to deliver high-quality, evidence-based cancer care to help patients achieve more breakthroughs and victories in their fight against cancer.
The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians, supported by McKesson Corporation to empower 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. Assess patients’ financial ability; may educate patients on assistance programs. Updates and maintains existing patient insurance eligibility, coverage, and benefits in the system. Supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards, and US Oncology’s Shared Values.
Responsibilities
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.
Assesses 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 on 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.
Obtains insurance pre-authorization or referral approval codes from Clinical Reviewer 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 (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 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 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 The ideal candidate for the Patient Benefits Representative will have the following background and experience:
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.
Clear verbal communication and appropriate terminology usage.
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.
Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
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; seeks expert resources when appropriate.
Demonstrates Adaptability: Handles day-to-day work challenges, adjusts to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience.
Uses Sound Judgment: Makes timely, cost-effective, and sound decisions under uncertainty.
Shows Work Commitment: Sets high standards of performance and pursues aggressive goals.
Commits to Quality: Delivers quality services; defines standards and evaluates against them; strives to improve 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. The role requires being present at the site during regularly scheduled hours; ability to sit or stand and talk or hear; full range of body motion; occasional lifting up to 40 lbs. 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. In-person interaction with co-workers, management, and/or clients. May require minimal travel by automobile to office sites.
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