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Maryland Oncology Hematology · 3 weeks ago

Patient Benefits Representative Sr.

Germantown, KY

Full-time

Onsite

Senior Level

$22.31/hr - $34.32/hr

5+ years exp

Maryland Oncology Hematology is seeking passionate professionals to provide exceptional cancer care. The Patient Benefits Representative Sr. is responsible for educating patients on insurance coverage and benefits, assessing financial ability, and maintaining insurance eligibility in the system.

Health CareHospitalMedicalOncology

Responsibilities

Prior to a patients first appointment, obtains preliminary diagnosis, insurance coverage information and demographics. Based upon diagnosis, estimates insurance coverage, financial obligation, and completes patient cost estimate forms. Prepares and completes appropriate reimbursement and liability forms for patients first appointment

During patients first appointment, educates patient on insurance coverage, pre-authorizations, 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. Reviews reimbursement and liability forms with patient and obtains approval signatures

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

Reviews and processes refund requests and adjustments. May discuss and resolve delinquent payments with patient and/or payers

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

Qualification

CPT coding knowledgeHCPCS coding knowledgeInsurance coverage knowledgeFinancial assistance knowledgeSound judgmentWork commitmentQuality commitmentVerbal communicationAdaptability