The US Oncology Network
Patient Benefits Representative Sr
The US Oncology Network, Frisco, Texas, United States, 75034
Patient Benefits Representative Sr
Join the team at The US Oncology Network’s Texas Oncology clinic located at 4461 Coit Road, #100, Frisco, Texas. The position is full‑time, Monday through Friday, 8:30 a.m. – 5:00 p.m., with occasional travel to partner sites as needed.
Overview The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and managing pre‑authorization and patient cost estimate processes. The role supports the Medical Oncology/Revenue Cycle Department and ensures compliance with the US Oncology Compliance Program.
Responsibilities
Prior to patient treatment, obtain insurance coverage information and demographics; educate patients on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
Assess patients’ ability to meet expenses, discuss payment arrangements, and educate on financial assistance programs; fill out Patient Cost Estimate forms based on diagnosis and coverage.
Complete appropriate reimbursement and liability forms for patient review and signature; forward required information and forms to the billing office.
Obtain pre‑authorization or referral approval codes from the Clinical Reviewer before each treatment.
Review patient account balances and notify the front desk of patients who need to meet with them.
Ensure accurate entry of patient co‑pay amounts into the system for correct front desk collection.
Verify and update demographics and insurance coverage at each patient visit per SOPs.
Stay current on available financial aid, develop relationships with providers, and network to obtain leads to additional assistance programs.
Adhere to confidentiality, state, federal, and HIPAA laws regarding patient records.
Maintain updated manuals, logs, forms, and documentation; perform additional duties as requested.
Qualifications Level 1
High school diploma or equivalent.
Minimum 3 years experience as a patient pre‑services coordinator or equivalent.
Proficiency with computer systems and Microsoft Office (Word and Excel).
Knowledge of CPT coding and HCPS coding application.
Clear verbal communication and appropriate terminology usage.
Completion of required e‑learning courses within 90 days of start.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in Finance, Business, or four years of revenue cycle experience preferred.
Minimum 3 years pre‑services coordinator experience and 2 years of patient benefits experience required.
Demonstrated knowledge and application of insurance coverage, benefits, and terminology.
Competencies
Possesses up‑to‑date technical and functional knowledge and is regarded as an expert in the area.
Exhibits adaptability, resilience, and flexibility in the face of changing demands.
Uses sound judgment to make timely, cost‑effective decisions under uncertainty.
Shows strong work commitment and pursues aggressive goals efficiently.
Commits to quality, defines standards, evaluates performance, and seeks continuous improvement.
Physical Demands Requires presence during business hours, sitting or standing, talking, hearing, and handling patients. Must be able to lift and carry items up to 40 lbs. Requires full range of motion, manual and finger dexterity, and normal vision and hearing.
Work Environment Involves exposure to communicable diseases, toxic substances, ionizing radiation, and medical preparations common to an oncology clinic. Requires in‑person interaction with staff and minimal automobile travel to office sites.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Human Resources
Industries Hospitals and Health Care
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Overview The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and managing pre‑authorization and patient cost estimate processes. The role supports the Medical Oncology/Revenue Cycle Department and ensures compliance with the US Oncology Compliance Program.
Responsibilities
Prior to patient treatment, obtain insurance coverage information and demographics; educate patients on coverage, benefits, co‑pays, deductibles, and out‑of‑pocket expenses.
Assess patients’ ability to meet expenses, discuss payment arrangements, and educate on financial assistance programs; fill out Patient Cost Estimate forms based on diagnosis and coverage.
Complete appropriate reimbursement and liability forms for patient review and signature; forward required information and forms to the billing office.
Obtain pre‑authorization or referral approval codes from the Clinical Reviewer before each treatment.
Review patient account balances and notify the front desk of patients who need to meet with them.
Ensure accurate entry of patient co‑pay amounts into the system for correct front desk collection.
Verify and update demographics and insurance coverage at each patient visit per SOPs.
Stay current on available financial aid, develop relationships with providers, and network to obtain leads to additional assistance programs.
Adhere to confidentiality, state, federal, and HIPAA laws regarding patient records.
Maintain updated manuals, logs, forms, and documentation; perform additional duties as requested.
Qualifications Level 1
High school diploma or equivalent.
Minimum 3 years experience as a patient pre‑services coordinator or equivalent.
Proficiency with computer systems and Microsoft Office (Word and Excel).
Knowledge of CPT coding and HCPS coding application.
Clear verbal communication and appropriate terminology usage.
Completion of required e‑learning courses within 90 days of start.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in Finance, Business, or four years of revenue cycle experience preferred.
Minimum 3 years pre‑services coordinator experience and 2 years of patient benefits experience required.
Demonstrated knowledge and application of insurance coverage, benefits, and terminology.
Competencies
Possesses up‑to‑date technical and functional knowledge and is regarded as an expert in the area.
Exhibits adaptability, resilience, and flexibility in the face of changing demands.
Uses sound judgment to make timely, cost‑effective decisions under uncertainty.
Shows strong work commitment and pursues aggressive goals efficiently.
Commits to quality, defines standards, evaluates performance, and seeks continuous improvement.
Physical Demands Requires presence during business hours, sitting or standing, talking, hearing, and handling patients. Must be able to lift and carry items up to 40 lbs. Requires full range of motion, manual and finger dexterity, and normal vision and hearing.
Work Environment Involves exposure to communicable diseases, toxic substances, ionizing radiation, and medical preparations common to an oncology clinic. Requires in‑person interaction with staff and minimal automobile travel to office sites.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Human Resources
Industries Hospitals and Health Care
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