The Patient Advocate Specialist plays a critical role in identifying, educating, and enrolling eligible hospital patients into the Health Insurance Premium Payment (HIPP) Program. This is a full-time, 5-day-per-week on-site role based at Massachusetts General Hospital, where you’ll work directly with patients and hospital partners. 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.
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.
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.