Patient Benefits Representative Sr. - San Marcos, TX

US Oncology, Inc. San Marcos , TX 78666

Posted 1 week ago

Position Summary

Texas Oncology is looking for a Patient Benefits Representative Sr. to join our team! This position will work and support our San Marcus, TX location; 1308 Wonder World Dr., San Marcos, TX. 78666. This is a Full-time Monday through Friday position, no on-call, and not on major holidays. Texas Oncology is the largest community oncology provider in the country and has approximately 600+ providers in 220+ sites across Texas and southeastern Oklahoma. 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 is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, high-touch, 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.

Why work for us?

Come join our team that is responsible for helping lead Texas Oncology in treating more patient diagnosed with cancer than any other provider in Texas. We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers.

The ideal candidate for the Patient Benefits Representative Sr. will have the following background and experience:

  • High school diploma or equivalent required.

  • Minimum two (2) 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.

  • Bilingual in English/Spanish preferred.

What does the Patient Benefits Representative Sr. do?

The Patient Benefits Representative Sr., under general supervision, responsible for collection of patient balances, working with sites performing account reviews and making corrections to patient accounts as needed. Obtains authorization for all infusion services as well as diagnostic testing

The essential duties and responsibilities:

  • Reviews, processes, and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.

  • Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs.

  • Obtains insurance authorization and pre-certification specifically for chemotherapy services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.

  • Patient collections and reviewing accounts and performing necessary action to ensure accuracy of patient billing.

  • 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 help 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.

Texas Oncology is part of the US Oncology Network and 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: Administrative

Post to:

  • M
  • CB
  • HEC

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.

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US Oncology, Inc.