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.