Patient Benefit Rep

About This Role

Educate patients on their insurance coverage, evaluate financial responsibility, and assist with navigating financial aid programs within a busy oncology practice. This role involves verifying insurance, explaining benefits, obtaining pre-authorizations, managing patient accounts, and ensuring compliance with healthcare guidelines.

Responsibilities

• Obtain and verify insurance coverage information and patient demographics prior to treatment
• Educate patients on their insurance benefits, including coverage details, co-pays, deductibles, coinsurance, and out-of-pocket expenses
• Assess patients’ ability to meet financial obligations and discuss payment arrangements when needed
• Work with Clinical Reviewers to obtain insurance pre-authorizations and referral approval codes prior to treatment
• Complete Patient Cost Estimate forms based on diagnosis, expected coverage, and assistance eligibility
• Review outstanding patient balances and notify appropriate front desk staff when a patient needs financial consultation
• Ensure correct co-pay amounts are entered into the system to support accurate collection at check-in
• Stay current on all available financial assistance programs and maintain strong professional relationships with aid providers
• Maintain confidentiality and adhere to all HIPAA, state, and federal guidelines
• Provide exceptional service as a liaison between patients, payers, and clinical staff

Requirements

• High school diploma or equivalent
• 3+ years of experience in patient pre-services, patient benefits, or similar healthcare financial coordination
• Proficiency in Microsoft Office (Word and Excel)
• Experience with healthcare computer systems
• Working knowledge of CPT and HCPCS coding
• Strong verbal communication skills
• Ability to explain financial and insurance terminology clearly
• Ability to complete required e-learning coursework within 90 days of hire

Qualifications

• High school diploma or equivalent required
• Minimum three (3) years of experience in patient pre-services, patient benefits, or similar healthcare financial coordination.

Nice to Have

• Experience with EMR systems
• Prior work in oncology, specialty medicine, or high-volume medical practices
• Strong understanding of insurance plans, coverage types, and reimbursement processes

Skills

* Required skills

Benefits