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.
