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The US Oncology Network · 2 days ago

Patient Benefits Representative Sr.

Germantown, KY

Full-time

Onsite

Senior Level

$22.31/hr - $34.32/hr

5+ years exp

The US Oncology Network is dedicated to providing exceptional cancer care and is seeking a Patient Benefits Representative Sr. to educate patients on insurance coverage and benefits, assess their financial ability, and assist with insurance eligibility updates. The role involves obtaining necessary insurance pre-authorizations, verifying patient information, and maintaining compliance with regulations while providing support to patients during their treatment journey.

CommunitiesHealth CareMedicalOncologyTest and Measurement

H1B Sponsor Likely

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 knowledgeRevenue cycle experienceSound judgmentWork commitmentQuality commitmentVerbal communicationAdaptability

Required

High school diploma or equivalent required

Minimum three (3) years pre-services coordinator experience required

Two (2) years of patient benefits experience required

Must be able to demonstrate knowledge of CPT coding and HCPS coding manuals

Must verbally communicate clearly and utilize the appropriate and correct terminology

Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology

Preferred

Associates degree in Finance, Business or four years revenue cycle experience preferred

Company

The US Oncology Network

Every day, The US Oncology Network helps approximately 3,300 providers deliver value-based, integrated care for patients—close to home.

Founded in 1992

The Woodlands, Texas, USA

10001+ employees

http://www.usoncology.com/

H1B Sponsorship

The US Oncology Network has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (1)