Patient Benefits Representative

US Oncology, Inc. Austin, TX
Position Summary ↵

Texas Oncology is searching for a Patient Benefits Representative. The Patient Benefits Representative is responsible for educating patients on insurance coverage and benefits. The Patient Benefits Representative will assess patients financial ability; may educate patient 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.

Texas Oncology delivers high-quality, high-touch care to help cancer patients achieve "More breakthroughs. More victories."® in their fight against cancer. We are an independent, physician-led practice delivering leading-edge technology and treatment options and conducting innovative research. Founders of the practice pioneered community-based care to enable more cancer patients to receive high-quality care while staying close to the critical support of family and friends.

Texas Oncology has more than 150 sites of service throughout Texas, with more than 350 physicians dedicated to serving our patients. On average, we treat more than 50,000 new cancer patients each year, with documented growth year over year. Texas Oncology pioneered the concept of community-based, outpatient, multidisciplinary cancer centers. We give local communities access to leading-edge technology that was previously only available in larger metropolitan areas. Texas Breast Specialists and Texas Urology Specialists are a part of Texas Oncology. Texas Oncology is an affiliate of The U.S. Oncology Network, which is owned by McKesson Specialty Health, a division of McKesson Corporation.

ESSENTIAL 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. Assess 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 upon 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.

* Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes 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, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (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 HIPPA laws and guidelines with regards to patient's records.

* Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.

* Other duties as requested or assigned.

MINIMUM QUALIFICATIONS:

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.

COMPETENCIES:

* Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as 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 inn 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.

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.

ESSENTIAL 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. Assess 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 upon 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.

* Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes 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, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (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 HIPPA laws and guidelines with regards to patient's records.

* Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.

* Other duties as requested or assigned.

MINIMUM QUALIFICATIONS:

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.

COMPETENCIES:

* Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as 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 inn 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.

The vision of Texas Oncology is to be the premier provider of oncology and hematology care in the Southwest. We have high standards for patient satisfaction and offer exceptional value in cancer care. We also strive to advance clinical research and develop innovative approaches to treatment of oncology and hematology disorders.

The mission of Texas Oncology is to provide \"More breakthroughs. More victories.\" To this end, we give patients access to the highest quality cancer care available today within their own local communities. Our cutting-edge technologies, treatments and research are offered in welcoming and comfortable environments. We maintain comprehensive quality oversight and responsible financial management. At all times, we pride ourselves in being moral, ethical and efficient as a medical practice and employer.

We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-k with a matching component, Life Insurance, Short-term and Long-term disability and Wellness & Perks Programs.

Come join our growing organization and enjoy knowing that you work for an organization dedicated to making the lives of others better.

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.

Category: Admin

* HEC

* M

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.