Patient Benefits Rep

Overview:

HOURLY RATE (DEPENDING ON SKILLS/EXPERIENCE): $24.21 - $31.58

 

SCOPE:Responsible for working assigned Patient Advocate WQs to ascertain if services will require patient out of pocket by obtaining and reviewing patient’s health plan benefits, out of pocket expense and estimate amounts owed.  Provide communication regarding estimates to sites and patient.  Assess further patient assistance if requested and work to obtain.  Determine payment status on patient accounts using account notes, statements and posted payments.  Reach out to patients to obtain payment, set up payment plan or enroll in further financial assistance. Answer and manage calls received in the Patient Advocate Phone Que.

Responsibilities:

RESPONSIBILITIES: 

• Perform timely review of assigned WQs to ascertain next steps; prioritizing requests based on due date, stat, urgent, etc. 
• Research and obtain patient benefits as it pertains to requested services.
• Estimate patient cost/financial counseling based on acquired patient benefits. For Imaging/Surgery//Self Pay patients/Radiation and Single Agent Treatments
• Verify the billing status of SNF patients, and communicate that information to the clinical and billing staff
• Research and enroll into patient copay cards
• Perform timely review of assigned Patient WQs to obtain monies owed for services rendered.
• Timely login to phone system and answering of calls; providing excellent customer service.
• Process Phone payments

Qualifications:

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent required.
• Associate degree in Business Admin or Related Field preferred
• 1-2 years experience in Healthcare Insurance in Healthcare environment required
• 1-2 years experience EMR required.

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.