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, 8:00a - 5:00p. This position may be classified as level 1 or Senior depending on relevant 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 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 to help patients achieve breakthroughs and victories in their fight against cancer. 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 and is supported by McKesson Corporation to empower a vibrant and sustainable patient care delivery system.
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 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 and identify sources; provides 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 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) to enable front desk collection.
At each patient visit, verifies and updates demographics and insurance coverage in the computer system according to SOPs.
Stays current on available financial aid; develops relationships with financial aid providers and networks to obtain leads to other aid programs.
Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
Other duties as requested or assigned.
Qualifications The ideal candidate will have the following background and experience.
Level 1
High school diploma or equivalent required.
Minimum three (3) years as a patient pre-services coordinator or equivalent.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
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 the position.
Level Sr (in Addition To Level 1 Requirements)
Associate degree in Finance or 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.
Demonstrated 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; accesses and uses expert resources when appropriate.
Demonstrates Adaptability: Handles day-to-day 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 goals efficiently.
Commits to Quality: Delivers quality products and/or services; defines standards for quality and evaluates processes and service against those standards.
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. The role requires being on-site during regular business hours, with the ability to sit or stand, talk or hear. May involve lifting up to 40 lbs and requires full range of body motion, including manual dexterity and eye-hand coordination. Walking and standing for extended periods may be required. Vision and hearing must be within normal range with corrections as needed.
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 coworkers, management, and/or clients is required. Some minimal travel to office sites may be necessary.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Human Resources
Industries
Hospitals and Health Care
San Antonio, TX
#J-18808-Ljbffr
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 mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help patients achieve breakthroughs and victories in their fight against cancer. 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 and is supported by McKesson Corporation to empower a vibrant and sustainable patient care delivery system.
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 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 and identify sources; provides 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 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) to enable front desk collection.
At each patient visit, verifies and updates demographics and insurance coverage in the computer system according to SOPs.
Stays current on available financial aid; develops relationships with financial aid providers and networks to obtain leads to other aid programs.
Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
Other duties as requested or assigned.
Qualifications The ideal candidate will have the following background and experience.
Level 1
High school diploma or equivalent required.
Minimum three (3) years as a patient pre-services coordinator or equivalent.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
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 the position.
Level Sr (in Addition To Level 1 Requirements)
Associate degree in Finance or 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.
Demonstrated 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; accesses and uses expert resources when appropriate.
Demonstrates Adaptability: Handles day-to-day 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 goals efficiently.
Commits to Quality: Delivers quality products and/or services; defines standards for quality and evaluates processes and service against those standards.
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. The role requires being on-site during regular business hours, with the ability to sit or stand, talk or hear. May involve lifting up to 40 lbs and requires full range of body motion, including manual dexterity and eye-hand coordination. Walking and standing for extended periods may be required. Vision and hearing must be within normal range with corrections as needed.
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 coworkers, management, and/or clients is required. Some minimal travel to office sites may be necessary.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Human Resources
Industries
Hospitals and Health Care
San Antonio, TX
#J-18808-Ljbffr