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

Position Summary

The Benefit & Advocacy Specialist (BAS) is responsible for enrolling HIPP-eligible Medicaid patients and qualified family members into employer-sponsored health insurance plans.

This role requires direct engagement with employers, policyholders, third-party administrators, benefit portals, and occasionally insurance brokers. Success in this role requires resilience, attention to detail, strong communication skills, and the ability to navigate complex insurance structures and employment regulations with confidence.

The BAS plays a critical role in ensuring patients maintain coverage while protecting reimbursement integrity and compliance standards.

Key Responsibilities

Employer Enrollment & Advocacy

Communicate with employers via phone, email, and text to coordinate enrollments
Review and evaluate benefit plans, rate sheets, and summaries of benefits
Navigate complex employment laws, COBRA regulations, and state subsidy programs
Assist with online and phone-based benefit enrollments
Calculate and resolve retroactive premiums and enrollment challenges
Obtain temporary IDs and expedite verification processes when needed
Ensure enrollment data and documentation are complete, accurate, and ready for state application submission
Advocate proactively to ensure employee and patient rights are respected

Patient & Family Support

Assist employees and family members in understanding benefit materials and enrollment requirements
Review paystubs to confirm accurate deductions and reimbursement alignment
Educate employees on plan options, timelines, and qualifying life events
Empower families by simplifying complex insurance concepts

Problem Solving & Case Resolution

Resolve enrollment-related issues, including qualifying life events (QLEs) and retroactive effective dates
Partner with Patient Helpers, Regional VPs, and State Operations teams to ensure continuity of coverage
Address employer, broker, or employee inquiries with professionalism and urgency
Maintain case momentum and prevent administrative delays

Collaboration & Continuous Improvement

Participate in weekly case review calls
Collaborate cross-functionally to ensure consistent execution and documentation standards
Contribute to process improvements as PFA scales
Perform additional duties as assigned

What Success Looks Like In This Role

Enrollments are accurate, timely, and compliant
Cases move forward without unnecessary delays
Employers experience PFA as professional, knowledgeable, and solutions-oriented
Patients and families feel informed, supported, and empowered
Documentation supports reimbursement recovery and audit readiness

Qualifications

Required Qualifications

Strong written and verbal communication skills
Demonstrated problem-solving and conflict resolution abilities
Ability to explain complex insurance and employment concepts in clear, simple terms
Excellent organizational skills and attention to detail
Strong time management and ability to manage multiple active cases
Ability to work independently while collaborating effectively across teams
Comfort navigating technology, benefit portals, and documentation systems
Ability to thrive in a fast-paced, high-growth organization

Preferred

Background in insurance, employee benefits, healthcare enrollment, or advocacy
Knowledge of employer-sponsored health plans, COBRA, ACA, or related employment law
Experience working with Medicaid or premium assistance programs

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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Benefit & Advocacy Specialist