Patient Benefits Represenatative

Overview

SCRI Oncology Partners, located in Nashville, Tenn., is a dedicated cancer treatment center led by globally recognized oncologists with disease expertise in cancer care and clinical research. This center offers patients state-of-the art personalized cancer care and opportunities to participate in clinical trials with innovative treatments. The practice conducts clinical trials through their affiliation with Sarah Cannon Research Institute (SCRI), a global leader in oncology research that has been offering and managing clinical trials in the community for over 30 years. Since its inception, SCRI has contributed to pivotal research that has helped advance the majority of new cancer therapies approved by the FDA today.

Why Work for Us?

We offer a competitive benefits package that includes -

• Medical
• Dental
• Vision
• Life Insurance
• Generous Paid Time Off (PTO)
• Company-paid Short-term and Long-term Disability Coverage
• 401k plan with company contribution
• Wellness program that rewards you practicing a healthy lifestyle
• Employee Assistance Program and Discount Program to some of your favorite retailers
• Free Parking
• Career Growth and Development
• Supportive Team and Resources

SCOPE

Under general supervision, the Patient Benefits Representative 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's Shared Values.

Responsibilities

• 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. 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. Completes appropriate reimbursement and liability forms for patient*s review and signature. Forwards appropriate information and forms to billing office.
• Obtains, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Reviews patient account balance and notify front desk of patients to meet with
• Ensures that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
• 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.

Qualifications

• High school diploma or equivalent required.
• Minimum three (3) years patient pre-services coordinator or equivalent required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrate knowledge of CPT coding and HCPS coding application.

PHYSICAL DEMANDS: 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.

WORK ENVIRONMENT: 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.

• 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. 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. Completes appropriate reimbursement and liability forms for patient*s review and signature. Forwards appropriate information and forms to billing office.
• Obtains, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Reviews patient account balance and notify front desk of patients to meet with
• Ensures that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
• 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.
• High school diploma or equivalent required.
• Minimum three (3) years patient pre-services coordinator or equivalent required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrate knowledge of CPT coding and HCPS coding application.

PHYSICAL DEMANDS: 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.

WORK ENVIRONMENT: 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.