patient financial services representative

FMOL Health

<div><p>The Patient Accounts Representative 2 works with patients, co-workers and external agencies to ensure the prompt payment and/or reimbursement of hospital and/or professional charges. The Patient Accounts Representative 2 is responsible for the monitoring of patient accounts which includes, but is not limited to: claim submissions, researching and reviewing back end denials; determining appropriate action for submission of provider claims; outbound and inbound calls from insurance carriers, providers and patients; payment posting; collections; account adjustments and appeals.</p></div>
<br><div><div><ul><li>Customer Service
<div><ul><li>Promptly answers inquiries from patients, co-workers, and employees regarding patient accounts in a kind and courteous manner.
</li></ul><ul><li>Assists in providing quality training and orientation for assigned employees.
</li></ul></div></li></ul><ul><li>Payer Relations
<div><ul><li>Advises patient or guarantor of third party payer benefits and estimated private payer amount and collects partial payments prior to admission in a manner that promotes the provision of high quality health care services by the department.
</li></ul><ul><li>Reviews patient papers and documentation for reported information accuracy, and researches errors on patient accounts, billing and insurance problems, and lost payments in order to ensure accurate record maintenance and prudent departmental operation.
</li></ul><ul><li>Makes written and verbal inquiries to third party payers, reconciles patient accounts, and makes payment arrangements in an effort to ensure that patients are free from financial burden and that patient interests are appropriately represented.
</li></ul><ul><li>Coordinates and originates payroll deduction actions for hospital employees in accordance with established policies and procedures, and oversees collection letter mail-outs for delinquent unpaid patient accounts in a prudent and efficient manner.
</li></ul><ul><li>Sends itemized patient account statements per attorney request or in response to subpoena in a professional and diligent manner.
</li></ul><ul><li>Reviews claims to make sure that payer specific billing requirements are met.
</li></ul><ul><li>Follows up on claims, determines and applies appropriate adjustments.
</li></ul><ul><li>Updates accounts.
</li></ul></div></li></ul><ul><li>Receivables
<div><ul><li>Works with external agencies and companies to provide patients with prompt reimbursement for hospital services. Interprets, explains, and counsels patient and family regarding hospital charges, services, and payment policies in a manner sensitive to the needs and financial situation of the patient.
</li></ul></div></li></ul><ul><li>Quality
<div><ul><li>Maintain a quality accuracy average of 95%
</li></ul><ul><li>Maintain a production set by management for specialty focus.
</li></ul><ul><li>Thoroughly completes assigned tasks with in the requested timeline.
</li></ul></div></li></ul><ul><li>Other Duties As Assigned
<div><ul><li>Performs other duties as assigned or requested.</li></ul></div></li></ul></div></div>
<br><div><ul><li>Must have 2 yrs experience of relevant experience. Bachelor's Degree substitutes 2 yrs exp. Associate's Degree, trade school, or certification substitutes 1 yr exp.
</li><li>Some examples of relevant experience include LPN, RN, Revenue Cycle, Accounting, Bookkeeping, Business, Billing, Coding or call center environments.
</li><li>High School or equivalent
</li><li>Must possess knowledge of ICD-9/10, CPT and HCPCS coding. Must have accurate data entry skills. Must be able to answer multiple phone lines with incoming and outgoing calls. Must understand the explanation of benefits of various managed care companies. Must be able to demonstrate teamwork and willingness to work in cooperation and support of others as well as comply with FMOLHS policies and procedures.</li></ul></div>

Patient Account Representative 2 - Hospital

CHRISTUS Health

<div><b>Description</b><p><br>
Summary:</p>
<p>The Patient Access Representative Senior performs duties relating to financial aspects of patient care, including financial counseling, billing and collection of accounts. Additionally, the job duties will include ensuring the hospital maintains compliance with Federal regulations, JCAHO, and Department of Health and Hospital compliance standards, along with communicating directly with patients and families, physicians, nurses, insurance companies and third party payers. The Patient Access Representative Senior also handles difficult patient account management issues escalated by other staff, and assists managers with various other duties as necessary.</p>
<p>Responsibilities:</p><br>
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Submits insurance claims to third party payors electronically and on paper. Follows up on unpaid third party claims to resolution (payment or denial).</li><li>
Evaluates and processes accounts for adjustments, charity, outside assistance or bad debt. Analyzes accounts to ensure full reimbursement and to satisfy patient and/or insurance company inquiries.</li><li>
Collects balances due from patients using phone calls, personal contact, statements, letters or third party services.</li><li>
Receives, processes and responds to correspondence or phone inquiries from patients, guarantors, insurance companies, attorneys, etc.</li><li>
Compiles data, tracks results and reports to management.</li><li>
May be assigned specialty responsibilities in the areas of refunds, reconciliation, balancing and/or posting and in data collection and analysis.</li><li>
Handles difficult patient account management issues referred by other staff.</li><li>
Supports the department in achieving established performance targets.</li><li>
Takes personal responsibility to ensure compliance with all policies, procedures and standards as promulgated by state and federal agencies, the hospital, and other regulatory entities.</li><li>
Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of assigned job duties.</li><li>
Assists managers with various duties including, but not limited to, review of write-offs, adjustments, refunds and discounts; coordinating work group activities; and training of other staff.</li></ul>
<p>Job Requirements:</p><br>
<p><b>Education/Skills</b></p>
<ul><li>High School Diploma or equivalent experience preferred</li></ul>
<p><b>Experience</b></p>
<ul><li>3-5 years of experience preferred</li></ul>
<p><b>Licenses, Registrations, or Certifications</b>
</p><ul><li>None required</li></ul><br>
<p></p>
<p>Work Schedule:</p><br>
<p>4 Days - 10 Hours</p>
<p>Work Type:</p><br>
<p>Full Time</p></div>

Patient Access Representative Senior - Admitting

LCMC Health

<div><p>Your job is more than a job</p><p></p><div><div><div><div><p><b>
Be the problem-solver before the visit!</b></p></div><p></p><div><p><br>
As a Patient Access Representative focused on Financial Clearance and Authorizations, you work behind the scenes&mdash;and directly with patients&mdash;to ensure care is approved, covered, and financially clear before services are delivered. Your attention to detail helps prevent delays, denials, and surprises, creating a smoother experience for both patients and care teams.</p></div><div><p>
You bring clarity, accuracy, and empathy to conversations about insurance, authorizations, and financial responsibility&mdash;making complex processes easier to understand.</p></div><div><p><b>
What You&rsquo;ll Do:</b></p></div><ul><li><p>
Verify insurance eligibility and benefits for scheduled and unscheduled services</p></li><li><p>
Obtain prior authorizations and referrals as required by payers</p></li><li><p>
Review patient accounts for financial clearance and resolve issues before services are rendered</p></li><li><p>
Communicate with insurance companies, providers, and internal teams to secure approvals</p></li><li><p>
Explain coverage, estimates, and financial responsibility to patients</p></li><li><p>
Assist with payment arrangements and financial assistance referrals when appropriate</p></li><li><p>
Maintain accurate documentation and protect patient confidentiality</p></li></ul><div><p><b>
What You Bring:</b></p></div><ul><li><p>
Strong customer service and communication skills</p></li><li><p>
Attention to detail and comfort working with insurance and authorization processes</p></li><li><p>
Ability to explain financial and coverage information clearly and confidently</p></li></ul><div><p><b>
Minimum Requirements:</b></p></div><ul><li><p>
High School Diploma or GED (or 2 years of applicable experience in lieu of education)</p></li><li><p>
2 years of customer service and/or healthcare experience</p></li></ul><p></p><div><p><b><br>
Help clear the path to care&mdash;so patients can focus on getting better!</b></p></div></div></div></div><p></p><p><b>
WORK SHIFT:
</b></p><p></p>Days (United States of America)<p><b>
LCMC Health is a community.</b></p><p>
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little &ldquo;come on in&rdquo; attitude is the foundation of LCMC Health&rsquo;s culture of everyday extraordinary</p><p></p><p><b>
Your extras</b></p><ul><li>
Deliver healthcare with heart.</li><li>
Give people a reason to smile.</li><li>
Put a little love in your work.</li><li>
Be honest and real, but with compassion.</li><li>
Bring some lagniappe into everything you do.</li><li>
Forget one-size-fits-all, think one-of-a-kind care.</li><li>
See opportunities, not problems &ndash; it&rsquo;s all about perspective.</li><li>
Cheerlead ideas, differences, and each other.</li><li>
Love what makes you, you - because we do</li></ul><p></p><p><b>
You are welcome here.</b></p><p>
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.</p><p></p><p>
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.</p><p></p><p><b><br>
Simple things make the difference.</b></p><p>
1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.</p><p>
2. To ensure quality care and service, we may use information on your application to verify your previous employment and background.</p><p>
3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.</p><p>
4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.</p></div>

Patient Access Representative (FT; Days) (Insurance Authorizations) - LCMC Health Westpark Campus

Southwoods Health

<div><div><b>Billing Customer Service Representative</b><br>
<b>Location: </b>Southwoods Executive Centre &ndash; Boardman, OH<br>
<b>Schedule:</b> Full-Time, Monday&ndash;Friday<br>
<b>Shift:</b> Weekly rotation (8:00am&ndash;4:30pm and 8:30am&ndash;5:00pm)<br>
<br>
<br>
<b>Be the Voice of Southwoods Health</b><br>
At Southwoods Health, we believe the patient experience extends beyond the exam room. As a Billing Customer Service Representative, you are the primary point of contact for our patients&rsquo; financial inquiries. We are looking for a compassionate, professional, and detail-oriented individual who can provide clear solutions while maintaining our high standard of &quot;patient-first&quot; care.<br>
If you have a knack for problem-solving and a passion for helping others navigate the financial side of healthcare, you&rsquo;ll fit right in.<br>
<br>
<br>
<b>How You&rsquo;ll Make a Difference:</b></div>
<ul><li><b>Patient Advocacy</b>: Act as the first point of contact for all incoming billing calls, providing courteous and timely resolutions to patient inquiries.</li>
<li><b>Financial Guidance:</b> Educate patients on financial assistance opportunities, assist in establishing payment plans, and negotiate settlements in accordance with facility policy.</li>
<li><b>Account Management: </b>Proactively manage worklists, monitor delinquent accounts, and coordinate the review and submission of accounts to collections when necessary.</li>
<li><b>HCAP Coordination</b>: Analyze financial assistance applications (HCAP) based on Federal Poverty Guidelines, maintain meticulous logs for auditors, and ensure all supporting documentation meets retention requirements.</li>
<li><b>Documentation &amp; Integrity: </b>Update patient records within the system to ensure a clear documentation trail and maintain 100% compliance with regulatory agency standards.</li></ul><br>
<div><br>
<br>
<b>What You&rsquo;ll Need to Succeed:</b></div>
<ul><li><b>Foundational Knowledge: </b>Training or coursework in business office activities and computer skills. Familiarity with medical terminology is required.</li>
<li><b>Expert Communication:</b> The ability to handle complex financial conversations with empathy, de-escalation skills, and a professional demeanor.</li>
<li><b>Analytical Thinking:</b> Strong problem-solving skills with the ability to use prudent judgment and reason to resolve account discrepancies.</li>
<li><b>Integrity: </b>Strong ethical and moral principles, with a commitment to maintaining patient confidentiality and 100% patient satisfaction.</li></ul><br>
<div><br>
<br>
<b>Why Southwoods?</b><br>
Join a healthcare system that values your contribution to the revenue cycle and patient experience. We offer a professional, stable work environment at our Southwoods Executive Centre with a consistent Monday&ndash;Friday schedule.<br>
<br>
<br>
<i>At Southwoods, it's not just about the treatment, but how you're treated.</i> #SWH<br>
www.southwoodshealth.com</div></div>

Billing Customer Service Representative

Blanchard Valley Health System

<div><p><b>PURPOSE OF THIS POSITION</b></p><p>
The PFS Call Center Representative serves as the hospital&rsquo;s primary contact for all patient billing inquiries. Acts as a liaison between Blanchard Valley Health System and patients, providers, and payers for all post-care matters related to account resolution. Provides information regarding hospital billing practices, policies, and patient billing statements. Assists patients in understanding billing statements to ensure swift resolution of outstanding balances. Fulfills the organization&rsquo;s mission of care and service by providing superior customer service to the patient community.</p><p><b>
JOB DUTIES/RESPONSIBILITIES</b></p><ul>
<li>
<b>Duty 1.</b> Responds promptly to patient inquiries regarding hospital billing procedures, policies, and statements. Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. within a specific response-to-call timeframe and with the intent to resolve the caller&rsquo;s concern immediately. Documents all patient accounts activities concisely, including future steps needed for resolution.</li>
<li><b>Duty 2.</b> Follows scripts as provided by the Patient Financial Services/Revenue Cycle Leadership to facilitate consistent and expedient account resolution. While also utilizing multiple resources to resolve patient inquiries while on the phone, preparing/reviewing billing correspondence, or in person.</li>
<li><b>Duty 3.</b> Responsible for insurance verification resulting in accurate billing and patient balances.</li>
<li><b>Duty 4.</b> Negotiates full payment from patients and helps them set up an agreeable payment plan and/or external payment program. Collects patient payments made over the counter, over the phone, and by mail daily; properly records all payment types (e.g., cash, check, debit, credit) and transactions into the computer system.</li>
<li><b>Duty 5.</b> Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB)</li>
<li><b>Duty 6.</b> Responsible for all cashier functions when needed at the Findlay campus. Including registration, financial counseling, and banking requirements. Providing timely and accurate reporting, patient, and associate satisfaction.</li>
<li><b>Duty 7.</b> Monitors, completes, and maintains appropriate productivity levels of assigned tasks in accordance with team standards.</li>
<li><b>Duty 8.</b> The above duties reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.</li>
<li><b>Duty 9. </b>Remains current on collection laws, Medicare/Medicaid laws, HCAP regulations and guidelines, third party funding requirements, and adheres to all requirements for compliancy.</li>
<li><b>Duty 10.</b> Maintains a thorough understanding and education of federal and state regulations and payer specific policies and requirements to promote compliant credit and collection practices. Adheres to HIPAA related privacy, security and transaction &amp; code set regulations in compliance with the federal guidelines. Accurately documents all account activity. Regularly attends and actively participates in staff meetings, in-service, and continuing education programs as offered. This provides needed educational updates for compliancy and organizational changes in the healthcare industry.</li>
<li><b>Duty 11.</b> Regularly attends and actively participates in staff meetings, training and continuing education that aligns with recognized improvement opportunities, payer policies and procedures and ensures to maintain up to date certifications. This could be remote and/or onsite as necessary, per the BVHS remote policy. Assists in other duties and projects as needed assigned by the supervisor and/or manager.</li>
</ul><p><b>
REQUIRED QUALIFICATIONS</b></p><ul>
<li>
High school graduate or GED equivalent</li>
<li>2-3 years of experience in medical billing and collections, or satisfactory completion of internal billing/self-pay billing assessment.</li>
<li>Certified Patient Financial Services Specialist certificate to be completed within 12 months of hire date.</li>
<li>Knowledge and experience with Microsoft office products and Window PC functionality</li>
<li>Excellent written and verbal communication with positive oriented interpersonal skills.</li>
<li>Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department. The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient&rsquo;s status. Must be able to interpret the appropriate information needed to identify each patient&rsquo;s requirements relative to their age-specific needs and to provide the care needed as described in the area&rsquo;s policies and procedures.</li>
</ul><p><b>
PREFERRED QUALIFICATIONS</b></p><ul>
<li>
Health administrative certification/degree or related field, and/or relevant work experience</li>
<li>Previous experience in a call center or &ldquo;dialer&rdquo; environment.</li>
<li>Medical terminology.</li>
<li>ICD 10 and/or CPT coding knowledge.</li>
</ul><p><b>
PHYSICAL DEMANDS</b></p><p>
This position requires a full range of body motion with intermittent bending, squatting, kneeling, and twisting. The associate must be able to sit for three hours, walk for one hour and stand for two hours per day. The associate must be able to lift 20 pounds. The individual must have excellent eye/hand coordination to operate the machines. This position requires corrected vision and hearing in the normal range.</p></div>
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</div><div></div><div><h3 class="jobSectionHeader"><b>Job Snapshot</b></h3>
<div><h4 class="jobSectionHeader"><b>Employee Type</b></h4>
Full-Time
</div><div><h4 class="jobSectionHeader"><b>Street Address</b></h4>
1100 East Main Cross Street
</div><div><h4 class="jobSectionHeader"><b>Location Map</b></h4>
</div><div><h4 class="jobSectionHeader"><b>Date Posted</b></h4>
03/12/2026
</div><div><h4 class="jobSectionHeader"><b>Job ID</b></h4>
19742
</div><div><h4 class="jobSectionHeader"><b>Shift</b></h4>
1st/Variable</div></div></div>

PFS Call Center Representative - 40 hrs/wk, 1st shift

UNM Hospital

<p></p><div><p><b>Minimum Offer</b></p><p><i>
$ 16.99/hr.</i></p><p><b>
Maximum Offer</b></p><p><i>
$ 24.79/hr.</i></p><p><b>
Compensation Disclaimer</b></p><p></p><p><i>
Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.</i></p><p>
Department: Patient Financial Services - UH</p><p><br>
FTE: 1.00<br>
Full Time<br>
Shift: Days</p><p><br>
Position Summary:<br>
Responsible for all patient accounts receivable functions as assigned. Reconcile, research, correct and submit third party claims and resubmit errors or denied claims. Communicate with insurance companies and government payers to resolve claim issues and ensure payment. Research and correct ICD 9, CPT coding, modifiers, revenue coding, occurrence codes and value codes as appropriate. Collaborate with the Income Support Division and the Medical Assistance Division in regards to eligibility for Medicaid. Interview and approve patients for UNMH charity programs. Provide customer service to patients by researching billing issues with various departments and resolving the issues. Reconcile remittance advices and patient accounts and resolve discrepancies. Ensure adherence to Hospital sand departmental policies and procedures. No patient care assignment.</p><div><br>
Detailed responsibilities:<br>
<ul><li>CLAIMS - Reconcile, review, research, coordinate and justify changes to claim forms and submit completed claim forms to third party payers</li><li>CLAIMS - Reconcile and review remittances; research as necessary to determine proper accounts; research and obtain correct information; complete remittance process</li><li>DENIALS - Follow up on claims denials; contact appropriate party to research, coordinate and justify needed information; make appropriate corrections, obtain approvals and resubmit claims denials for payments; appeal denials through the payer required appeals process
</li><li>FINANCIAL ASSISTANCE - Interview patients and complete the application process for State/Government programs; maintain MOSAA certification with the State; interview and approve patients for UNM Hospital charity and discount programs</li><li>COLLECTIONS - Follow up on the collection of patient accounts, contact appropriate party (third party payers, other hospitals, patients) to obtain needed information; make appropriate corrections; obtain approvals and resubmit claim for payment</li><li>CLAIMS - Research unpaid claims; contact patients to obtain necessary information to assist with claims process; secure payments or negotiate payment plans</li><li>CASH - Reconcile and complete cash reconciliation reports; balance and post payments, contractual allowances, and denials</li><li>CREDIT - Research, resolve and reconcile credit balances to include processing the refund request or take back with a payer</li><li>COORDINATION - Work with various University Hospital departments to obtain additional information regarding services rendered to include correct coding and documentation</li><li>TRAINING - Perform training with registration and admitting personnel to assure proper registration and knowledge of business practices to include financial assistance programs</li><li>COMMUNICATION - Handle patient inquiries, complaints and customer service issues by phone, in person or via the email; research and resolve the issue
</li><li>DATA - Perform data entry and research using various hospital system programs</li><li>PATIENT ACCOUNTING - Maintain current knowledge of regulations for Third Party Payers, Medicare, Medicaid and knowledge of claims coding and formats</li><li>DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops</li><li>CUSTOMER RELATIONS - Establish and maintain good rapport and effective working relationships with patients, visitors, physicians and Hospitals employees</li></ul></div><h4 class="jobSectionHeader"><b><br>
Qualifications</b></h4><i>
Related Education and Experience may be substituted for one another on a year for year basis.</i><div><br>
Education:<br>
Essential:<br>
<ul><li>High School or GED Equivalent</li></ul></div><p><br>
Experience:<br>
Essential:<br>
2 years directly related experience<br>
<br>
Nonessential:<br>
Bilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, Va\ietnamese, or Navajo</p><div><br>
Credentials:<br>
Essential:<br>
<ul><li>Not Applicable/Not Required</li></ul></div><p><br>
Physical Conditions:<br>
Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.</p><div><br>
Working conditions:<br>
Essential:<br>
<ul><li>No or min hazard, physical risk, office environment
</li><li>Tuberculosis testing is completed upon hire and additionally as required</li></ul></div></div>

PATIENT SERVICES REPRESENTATIVE

Texas Oncology

<div>Overview:<div></div><div><b><br>
The US Oncology Network</b> is looking for a <b>Patient Benefits Representative</b> to join our team at <b>Texas Oncology</b>. This full-time position will support the <b>Revenue Cycle Department</b> at our 3010 Harrison Avenue clinic in Beaumont, Texas with some travel. Typical work week is Monday through Friday, 8:30a - 5:00p.</div><div></div><p><br>
This position will be a level 1or Sr depending on relevant candidate experience.</p><p></p><div><br>
As a part of <b>The</b> <b>US Oncology Network</b>, <b>Texas Oncology</b> delivers high-quality, evidence-based care to patients close to home. <b>Texas Oncology </b>is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, 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&mdash;at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve &ldquo;More breakthroughs. More victories.&rdquo; &reg; in their fight against cancer. Today, <b>Texas Oncology</b> treats half of all Texans diagnosed with cancer on an annual basis.</div><div></div><div><b><br>
The</b> <b>US Oncology Network</b> is one of the nation&rsquo;s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. <b>The</b> <b>US Oncology Network</b> is supported by <b>McKesson </b>Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.</div><div></div><p><b><br>
What does the Patient Benefits Representative do? (including, but not limited to):</b></p><p>
The Patient Benefits Representative, under general supervision is responsible for educating patient on insurance coverage and benefits. Assess patients financial ability; may educate patient on assistance programs. Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology&rsquo;s Shared Values.</p>
Responsibilities:
<p><b>
The essential duties and responsibilities (including, but not limited to):</b></p><ul><li>
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.
</li><li>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. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
</li><li>Completes appropriate reimbursement and liability forms for patient&rsquo;s review and signature. Forwards appropriate information and forms to billing office.</li><li>
Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.</li><li>
Review patient account balance and notify front desk of patients to meet with</li><li>
Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately</li><li>
At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
</li><li>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.</li><li>
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records.
</li><li>Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
</li><li>Other duties as requested or assigned.</li></ul>
Qualifications:
<p><b>
The ideal candidate for the Patient Benefits Representative will have the following background and experience:
 </b></p><p><b>Level 1</b></p><ul><li>
High school diploma or equivalent required.
</li><li>Minimum three (3) years patient pre-services coordinator or equivalent required.
</li><li>Proficiency with computer systems and Microsoft Office (Word and Excel) required.
</li><li>Demonstrate knowledge of CPT coding and HCPS coding application.</li><li>
Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.</li><li>
Must successfully complete required e-learning courses within 90 days of occupying position.</li></ul><p><b>
Level Sr (in addition to level 1 requirements)</b></p><ul><li>
Associates degree in Finance, Business or four years revenue cycle experience preferred.
</li><li>Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
</li><li>Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.</li></ul><p></p><p><b><br>
Competencies:</b></p><ul><li>
Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate.</li><li>
Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.</li><li>
Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.</li><li>
Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.</li><li>
Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.</li></ul><p><b>
Physical Demands:</b></p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.</p><p><b><br>
</b></p><p><b>Work Environment:</b></p><div>
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.</div></div>

Patient Benefits Representative Sr

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