Maryland Oncology Hematology · 4 days ago
Patient Benefit Representative team lead
Bedford, VA
Full-time
Onsite
Mid Level
3+ years expMaryland Oncology Hematology is part of The US Oncology Network, which is the largest community oncology provider in the country. The Patient Benefits Representative Lead will educate patients on insurance coverage and benefits, support the onboarding of new hires, and maintain patient insurance information 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
Maintains current knowledge on TxO Standard Operating Procedures (SOPs) and best practices, and supports the on the job training and onboading of new PBR staff
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)
Maintains updated manuals, logs, forms, and documentation. Performs additional duties requested. Other duties as requested or assigned
Qualification
Required
High school diploma or equivalent required
Minimum 3 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 6 years of revenue cycle experience preferred
Company
Maryland Oncology Hematology
Maryland Oncology Hematology is a community based healthcare institution specialized in research and treatment of cancer patients.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
David Weng
Partner
Recent News
Maryland Daily Record
2024-12-17
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