Company Description

About Patient Funding Alternatives (PFA)

At Patient Funding Alternatives (PFA), we remove the barriers that keep Medicaid-eligible and medically underserved individuals from getting the care they deserve. We partner with hospitals and health systems across the country to help patients secure coverage through employer-sponsored insurance — simplifying the process, protecting patients, and strengthening hospital outcomes.

As the only organization in the U.S. offering a full Premium Assistance Enrollment service supported by dedicated Patient Advocates within partner hospitals, we make access to coverage easier, faster, and more compassionate.

PFA is growing rapidly nationwide, and our success is built on people who care deeply about helping others. We believe our employees are our most valuable resource, and we’re committed to maintaining a healthy work/life balance within a culture grounded in empathy, teamwork, and respect.

If you’re passionate about guiding patients through complex healthcare systems, advocating for fairness, and making a measurable impact every day — PFA is where you belong.

Job Description

The Patient Advocate Specialist plays a critical role in identifying, educating, and enrolling eligible hospital patients into the Health Insurance Premium Payment (HIPP) Program. You'll clearly explain program details, gather required documentation, and serve as a compassionate, professional advocate throughout each step of the enrollment process.

This role demands mission-driven advocacy, proactive problem-solving, empathetic communication, and resilience—all while balancing compassion with an urgency to ensure patients receive timely support. By facilitating employer-sponsored health insurance coverage, the Patient Helper Program helps medically complex Medicaid beneficiaries access comprehensive care.

We’re looking for driven individuals with a “can-do” spirit, unwavering perseverance, and the capacity to support diverse patient populations navigating complex healthcare systems.

Key Responsibilities

Patient Engagement & Advocacy

Educate patients and families in a clear, compassionate, and culturally sensitive manner about the HIPP program.
Assess family dynamics and adapt communication style to effectively meet their needs.
Obtain necessary authorizations and documentation from patients/families.
Foster trust with patients while maintaining appropriate professional boundaries.
Demonstrate cultural competence and empathy when engaging with vulnerable populations.

HIPP Enrollment & Case Management

Accurately collect all essential data for HIPP applications (e.g., employer information, insurance details).
Employ proactive problem-solving to overcome barriers and ensure timely, accurate submissions.
Collaborate seamlessly with the Patient Financial Assistance (PFA) team to finalize enrollments.
Consistently deliver against performance metrics such as enrollments completed, case resolution time, and documentation accuracy.

Program Maintenance & Benefit Coordination

Clarify how employer-provided health insurance works in coordination with Medicaid.
Verify and update ongoing patient eligibility for HIPP to maintain continuity.
Assist with resolving insurance-related issues upon request from patients or clients.

Technology & Documentation

Utilize PFA’s CRM/case management system to manage referrals and patient records.
Upload, scan, and securely transmit required documentation.
Record patient interactions meticulously in compliance with privacy and legal standards.
Efficiently operate Apple tools such as iPads and iPhones for enrollment-related tasks.

Client & Hospital Relationship Management

Represent PFA as the onsite contact at the hospital.
Establish and maintain collaborative relationships with hospital staff, state agency personnel, and community partners.
Always uphold the organization’s values with ethical integrity and professionalism.

Qualifications

Required Qualifications

High school diploma or GED and completion of formal training in customer service, patient services, healthcare administration, social services, or case management.
Foundational knowledge of healthcare terminology and insurance processes gained via coursework or certification.
Ability to pass hospital credentialing, including vaccinations and drug/alcohol screening.

Preferred Qualifications

Associate’s or Bachelor’s degree in Social Work, Healthcare Administration, Public Health, or related field.
Training in motivational interviewing, trauma-informed care, or medical billing/coding.
Continuing education in Medicaid/Medicare eligibility, health equity, or patient advocacy.
Three-Five years’ experience in patient-facing roles within a healthcare setting.
Full Bilingual proficiency in Spanish is strongly preferred.

Core Skills & Competencies

Technical Skills-Preferred

Proficiency with CRM or case management systems.
Knowledge of Medicaid/Medicare eligibility and benefits coordination.
Ability to interpret medical billing and insurance documents.
Strong compliance-based documentation practices.

Interpersonal Skills

Active listening and empathetic communication.
De-escalation tactics for emotionally distressed patients.
Cultural awareness and sensitivity in communication.
Collaboration with cross-functional teams, including hospital and internal staff.

Key Traits for Success

Mission-Driven Advocacy – Consistently puts patient needs first.
Ego Resilience – Thrives amid adversity and changing demands.
Empathy – Provides compassionate support while ensuring professionalism.
Urgency – Balances speed and sensitivity in patient interactions.
Detail Orientation – Ensures accuracy and completeness in documentation.
Cultural Competence – Demonstrates respect and understanding of diverse experiences.
Adaptability – Successfully operates in evolving policy and procedural environments.

Additional Information

Our Benefits – Supporting You Inside and Out

At Patient Funding Alternatives, we know that caring for others starts with caring for our own people. That’s why we offer a comprehensive, industry-leading benefits package designed to support your health, your future, and your wellbeing. Our team members enjoy medical, dental, and vision coverage through UnitedHealthcare and Guardian, employer-paid life and disability insurance, and a 401(k) plan with company match. We also invest in your wellness — with up to $100 annual reimbursement for fitness, mindfulness, and wellness activities, plus access to mental health tools like the Calm Health app and a 24/7 Employee Assistance Program. From flexible spending accounts to nationwide fitness programs and virtual care, PFA is committed to helping you stay healthy, balanced, and thriving — at work and beyond.

Patient Funding Alternatives

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Patient Advocate Specialist