Patient Benefit Representative

About This Role

Educate patients on insurance coverage and benefits, assess their financial ability, and help them access financial assistance programs. Maintain patient insurance eligibility and collaborate with the billing office to ensure accurate patient cost estimates.

Responsibilities

• Obtain patient insurance coverage information and demographics prior to treatment
• Educate patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses
• Assess patients’ ability to meet expenses and discuss payment arrangements
• Educate patients on financial assistance programs and assist with completing required forms
• Complete the Patient Cost Estimate form based on diagnosis, insurance coverage, and financial assistance options
• Complete required reimbursement and liability forms for patient review and signature
• Forward all appropriate information and forms to the billing office
• Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer prior to each treatment
• Review patient account balances and notify the front desk of patients who need financial consultation
• Ensure patient co–pay amounts are accurately entered into the system or communicated to the front desk for correct collection
• Verify and update demographics and insurance coverage at each patient visit according to Standard Operating Procedures (SOPs)
• Stay current on available financial aid resources and develop professional relationships with financial assistance providers
• Adhere to confidentiality requirements and all state, federal, and HIPAA guidelines regarding patient records

Requirements

• High school diploma or equivalent
• Minimum three (3) years patient pre-services coordinator or equivalent experience
• Proficiency with computer systems and Microsoft Office (Word and Excel)
• Knowledge of CPT coding and HCPS coding application
• Ability to verbally communicate clearly and utilize appropriate terminology

Qualifications

• High school diploma or equivalent
• Minimum three (3) years patient pre-services coordinator or equivalent required.

Skills

* Required skills

Benefits