Patient Benefits Representative

About the position

The Patient Benefits Representative at Texas Oncology plays a crucial role in supporting patients by educating them on insurance coverage and benefits, assessing their financial capabilities, and guiding them through financial assistance programs. This full-time position is part of the Urology team at the Fort Worth Clearfork clinic, contributing to the mission of delivering high-quality, evidence-based cancer care to patients in their communities.

Responsibilities

• Obtain insurance coverage information and demographics prior to patient treatment.
• Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients' ability to meet expenses and discuss payment arrangements.
• Educate patients on financial assistance programs and assist with completing forms.
• Complete Patient Cost Estimate form based on diagnosis and estimated insurance coverage.
• Complete appropriate reimbursement and liability forms for patient review and signature.
• Obtain insurance pre-authorization or referral approval codes prior to treatment from Clinical Reviewer.
• Review patient account balance and notify front desk of patients needing to meet with staff.
• Verify and update patient demographics and insurance coverage in the system at each visit.
• Stay current on available financial aid and develop relationships with financial aid providers.
• Adhere to confidentiality, state, federal, and HIPAA laws regarding patient records.
• Maintain updated manuals, logs, forms, and documentation.

Requirements

• High school diploma or equivalent required for Level 1.
• Minimum three (3) years of patient pre-services coordinator or equivalent experience required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Knowledge of CPT coding and HCPS coding application required.
• Ability to communicate clearly and use appropriate terminology required.
• Must complete required e-learning courses within 90 days of occupying the position for Level 1.
• For Level Sr: 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 for Level Sr.
• Demonstrated knowledge and appropriate application of insurance coverage benefits and terminology required for Level Sr.

Nice-to-haves

• Associates degree in Finance or Business preferred for Level Sr.
• Four years of revenue cycle experience preferred for Level Sr.