US Oncology Inc.
Patient Benefits Representative Sr
US Oncology Inc., Granite Heights, Wisconsin, United States
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 Medical Oncology Department at our 12221 Renfert Way Ste 300 clinic in Austin, Texas. The typical work week is Monday through Friday, 8:30 a.m. – 5:00 p.m.
This position will be a Level 1 or Senior level 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 founders pioneered community‑based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission remains the same today—at Texas Oncology, we use leading‑edge technology and research to deliver high‑quality, evidence‑based cancer care to help our patients achieve “More breakthroughs. More victories.” in their fight against cancer. Today, 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 dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation, focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.
What does the Patient Benefits Representative do? The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits. The representative assesses patients’ financial ability and may educate patients on assistance programs. The role also updates and maintains existing patient insurance eligibility, coverage, and benefits in the system, and 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 the 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 to provide assistance with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
Completes appropriate reimbursement and liability forms for the patient’s review and signature; forwards appropriate information and forms to the billing office.
Obtains insurance pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
Reviews patient account balance and notifies the front desk of patients to meet with the billing office.
Ensures that patient co‑pay amount is correctly entered into the system (or conveyed), enabling the front desk to collect the amount 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 assistance programs; develops professional relationships with financial aid providers; networks with financial aid providers 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 for the Patient Benefits Representative will have the following background and experience:
Level 1
High school diploma or equivalent required.
Minimum three (3) years of patient pre‑services coordinator or equivalent experience required.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
Demonstrates knowledge of CPT coding and HCPCS coding application.
Must be able to communicate verbally and utilize the appropriate terminology.
Must complete required e‑learning courses within 90 days of beginning the position.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in finance, business, or four years of revenue cycle experience preferred.
Minimum three (3) years of 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 expertise; possesses up‑to‑date knowledge of the profession and industry; is regarded as an expert in the technical/functional area and accesses 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 under conditions of uncertainty.
Shows work commitment; sets high performance standards; 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 and 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 pounds. Requires corrected vision and hearing to a 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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This position will be a Level 1 or Senior level 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 founders pioneered community‑based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission remains the same today—at Texas Oncology, we use leading‑edge technology and research to deliver high‑quality, evidence‑based cancer care to help our patients achieve “More breakthroughs. More victories.” in their fight against cancer. Today, 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 dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation, focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.
What does the Patient Benefits Representative do? The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits. The representative assesses patients’ financial ability and may educate patients on assistance programs. The role also updates and maintains existing patient insurance eligibility, coverage, and benefits in the system, and 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 the 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 to provide assistance with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
Completes appropriate reimbursement and liability forms for the patient’s review and signature; forwards appropriate information and forms to the billing office.
Obtains insurance pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
Reviews patient account balance and notifies the front desk of patients to meet with the billing office.
Ensures that patient co‑pay amount is correctly entered into the system (or conveyed), enabling the front desk to collect the amount 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 assistance programs; develops professional relationships with financial aid providers; networks with financial aid providers 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 for the Patient Benefits Representative will have the following background and experience:
Level 1
High school diploma or equivalent required.
Minimum three (3) years of patient pre‑services coordinator or equivalent experience required.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
Demonstrates knowledge of CPT coding and HCPCS coding application.
Must be able to communicate verbally and utilize the appropriate terminology.
Must complete required e‑learning courses within 90 days of beginning the position.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in finance, business, or four years of revenue cycle experience preferred.
Minimum three (3) years of 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 expertise; possesses up‑to‑date knowledge of the profession and industry; is regarded as an expert in the technical/functional area and accesses 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 under conditions of uncertainty.
Shows work commitment; sets high performance standards; 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 and 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 pounds. Requires corrected vision and hearing to a 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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