Patient Benefits Representative
Texas Oncology, San Antonio, TX, 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 Revenue Cycle Department at our 11130 Christus Hills Suite 210 clinic in San Antonio, Texas, with possible travel to Next Oncology, Westover Hills, and the Central Business Office. Typical work week is Monday through Friday, 8:00 a.m.–5:00 p.m. This role may be a Level 1 or Sr depending on relevant candidate experience. Texas Oncology, the largest community oncology provider in the country, treats half of all Texans diagnosed with cancer annually.
Responsibilities
Prior to a patient receiving treatment, obtain insurance coverage information and demographics; 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, expected coverage, and assistance.
Complete appropriate reimbursement and liability forms for patient review and signature; forward information and forms to the billing office.
Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
Review patient account balance and notify front desk of patients to meet with.
Ensure the patient co‑pay amount is correctly entered into the system to allow front desk to collect accurately.
At each visit, verify and update demographics and insurance coverage in the computer system according to SOPs.
Stay current on available financial aid, develop professional relationships with aid providers, and network to obtain leads to other programs.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
Maintain updated manuals, logs, forms, and documentation; perform additional duties as requested.
Qualifications
Level 1
High school diploma or equivalent required.
Minimum three (3) years as a patient pre‑services coordinator or equivalent.
Proficiency with Microsoft Office (Word and Excel) required.
Knowledge of CPT and HCPCS coding applications.
Strong verbal communication skills and correct terminology usage.
Complete required e‑learning courses within 90 days of starting the position.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in Finance, Business, or a minimum of four years of revenue cycle experience preferred.
Minimum three (3) years as a pre‑services coordinator and two (2) years of patient benefits experience.
Demonstrate knowledge and application of insurance coverage benefits and terminology.
Competencies
Up‑to‑date technical knowledge and ability to use other resources when appropriate.
Adaptability to day‑to‑day challenges, shifting priorities, and rapid change.
Sound judgment to make timely, cost‑effective decisions under uncertainty.
High work commitment: set high standards, pursue goals efficiently.
Commitment to quality: define standards, evaluate performance, manage quality, and improve efficiencies.
Physical Demands
Required to sit, stand, walk, talk, and hear as needed. May lift items weighing up to 40 lbs. Requires full range of body motion, eye‑hand coordination, and corrected vision and hearing. Reasonable accommodations may be made for disabilities.
Work Environment
Includes exposure to communicable diseases, toxic substances, ionizing radiation, and medical preparations common to an oncology clinic. Work involves in‑person interaction with coworkers, management, and clients, and may require occasional travel by automobile.
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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 Revenue Cycle Department at our 11130 Christus Hills Suite 210 clinic in San Antonio, Texas, with possible travel to Next Oncology, Westover Hills, and the Central Business Office. Typical work week is Monday through Friday, 8:00 a.m.–5:00 p.m. This role may be a Level 1 or Sr depending on relevant candidate experience. Texas Oncology, the largest community oncology provider in the country, treats half of all Texans diagnosed with cancer annually.
Responsibilities
Prior to a patient receiving treatment, obtain insurance coverage information and demographics; 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, expected coverage, and assistance.
Complete appropriate reimbursement and liability forms for patient review and signature; forward information and forms to the billing office.
Obtain insurance pre‑authorization or referral approval codes from the Clinical Reviewer prior to each treatment.
Review patient account balance and notify front desk of patients to meet with.
Ensure the patient co‑pay amount is correctly entered into the system to allow front desk to collect accurately.
At each visit, verify and update demographics and insurance coverage in the computer system according to SOPs.
Stay current on available financial aid, develop professional relationships with aid providers, and network to obtain leads to other programs.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
Maintain updated manuals, logs, forms, and documentation; perform additional duties as requested.
Qualifications
Level 1
High school diploma or equivalent required.
Minimum three (3) years as a patient pre‑services coordinator or equivalent.
Proficiency with Microsoft Office (Word and Excel) required.
Knowledge of CPT and HCPCS coding applications.
Strong verbal communication skills and correct terminology usage.
Complete required e‑learning courses within 90 days of starting the position.
Level Sr (in addition to Level 1 requirements)
Associate’s degree in Finance, Business, or a minimum of four years of revenue cycle experience preferred.
Minimum three (3) years as a pre‑services coordinator and two (2) years of patient benefits experience.
Demonstrate knowledge and application of insurance coverage benefits and terminology.
Competencies
Up‑to‑date technical knowledge and ability to use other resources when appropriate.
Adaptability to day‑to‑day challenges, shifting priorities, and rapid change.
Sound judgment to make timely, cost‑effective decisions under uncertainty.
High work commitment: set high standards, pursue goals efficiently.
Commitment to quality: define standards, evaluate performance, manage quality, and improve efficiencies.
Physical Demands
Required to sit, stand, walk, talk, and hear as needed. May lift items weighing up to 40 lbs. Requires full range of body motion, eye‑hand coordination, and corrected vision and hearing. Reasonable accommodations may be made for disabilities.
Work Environment
Includes exposure to communicable diseases, toxic substances, ionizing radiation, and medical preparations common to an oncology clinic. Work involves in‑person interaction with coworkers, management, and clients, and may require occasional travel by automobile.
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