Maryland Oncology Hematology
Patient Benefits Representative
Maryland Oncology Hematology, San Antonio, Texas, United States, 78208
Join to apply for the
Patient Benefits Representative
role at
Texas Oncology .
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 5206 Research Drive location in San Antonio, Texas. Typical work week is Monday through Friday, 9:30 a.m. – 6:00 p.m. Become a valued member of a cohesive team that fosters collaboration, encourages open communication, and supports one another in achieving shared goals. Embrace the opportunity to work alongside diverse talents, leverage individual strengths, and contribute to a positive and inclusive work environment where everyone's input is valued and teamwork leads to collective success. This position will be a level 1 or Sr depending on relevant candidate experience.
What does the Patient Benefits Representative do? 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 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
Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
Assess patients' ability to meet expenses and discuss 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, complete Patient Cost Estimate form.
Complete appropriate reimbursement and liability forms for patient’s review and signature. Forward appropriate information and forms to billing office.
Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer 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, verify and update demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
Stay current on available financial aid. Develop professional relationships with financial aid providers. Network with financial aid providers to obtain leads to other aide programs.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records.
Maintain updated manuals, logs, forms, and documentation. Perform 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 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.
Level Sr (in addition to Level 1 requirements)
Associate’s 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 an 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 evaluated products, processes, and service 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 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.
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Patient Benefits Representative
role at
Texas Oncology .
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 5206 Research Drive location in San Antonio, Texas. Typical work week is Monday through Friday, 9:30 a.m. – 6:00 p.m. Become a valued member of a cohesive team that fosters collaboration, encourages open communication, and supports one another in achieving shared goals. Embrace the opportunity to work alongside diverse talents, leverage individual strengths, and contribute to a positive and inclusive work environment where everyone's input is valued and teamwork leads to collective success. This position will be a level 1 or Sr depending on relevant candidate experience.
What does the Patient Benefits Representative do? 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 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
Prior to a patient receiving treatment, obtain insurance coverage information and demographics; educate patient on insurance coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
Assess patients' ability to meet expenses and discuss 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, complete Patient Cost Estimate form.
Complete appropriate reimbursement and liability forms for patient’s review and signature. Forward appropriate information and forms to billing office.
Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer 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, verify and update demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
Stay current on available financial aid. Develop professional relationships with financial aid providers. Network with financial aid providers to obtain leads to other aide programs.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records.
Maintain updated manuals, logs, forms, and documentation. Perform 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 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.
Level Sr (in addition to Level 1 requirements)
Associate’s 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 an 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 evaluated products, processes, and service 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 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.
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