Patient Benefits Representative Sr.

Regional Cancer Care Associates (RCCA) is looking for an exceptional Patient Benefits Representative Sr. to join the team. This position 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. This individual must also possess strong multi-tasking abilities and bring positivity and passion to their work. If you want to join a team that is on the cutting edge of cancer care, while always putting the patient first, we want to hear from you! While some experience is preferred, we are very open to new grads looking to explore oncology care.

Employment Type: Full Time

Shift Day, no nights or weekends!
Benefits: M/D/V, Life Ins., 401(k)
Location: Hackensack, NJ

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Prior to a patients first appointment, obtains preliminary diagnosis, insurance coverage information and demographics. Based upon diagnosis, estimates insurance coverage, financial obligation, and completes patient cost estimate forms. Prepares and completes appropriate reimbursement and liability forms for patients first appointment.
• During patients first appointment, educates patient on insurance coverage, pre-authorizations, 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. Reviews reimbursement and liability forms with patient and obtains approval signatures.
• Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with
• Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
• Reviews and processes refund requests and adjustments. May discuss and resolve delinquent payments with patient and/or payers.
• At each patient visit, 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.
• Associates degree in Finance, Business or four years revenue cycle experience preferred. Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
• Must be able to demonstrate knowledge of CPT coding and HCPS coding manuals.
• Must verbally communicate clearly and utilize the appropriate and correct terminology.
• Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology