P

Patient Funding Alternatives

Guides Medicaid to premium-assisted insurance enrollment

Patient Advocate Specialist - Bilingual Spanish

Full-Time
$65k/yr
Junior, Mid
Bachelor's, Associate's
New York, NY, USA
HybridOn-site coverage is required as needed.
Social & Community ServicesCase Management & Advocacy

About the job

Requirements
  • High school diploma or GED.
  • Full bilingual proficiency in Spanish.
  • At least 2 years of experience in a patient-facing or customer-facing role measured on activity or outcomes.
  • Ability to work independently on-site with limited daily supervision.
  • Working proficiency with a customer relationship management or case management system, plus iPad and iPhone.
  • Ability to pass hospital credentialing, including required vaccinations and drug/alcohol screening.
Responsibilities
  • Identify and approach eligible patients and families from hospital referrals and daily census review.
  • Explain the Health Insurance Premium Payment program clearly and compassionately, adapting communication to each family's situation.
  • Work through hesitation, confusion, and mistrust without pressuring patients.
  • Gather authorizations and documentation needed to move applications forward.
  • Build trust with patients while maintaining professional boundaries.
  • Collect complete and accurate application data, including employer details, plan information, premium costs, and dependent information.
  • Resolve issues that could stall cases, including unresponsive employers, missing paperwork, and eligibility questions.
  • Hand off applications to the State Operations and Benefit & Advocacy teams for submission, approval, and post-enrollment support.
  • Own each caseload from first contact through enrollment.
  • Explain how employer coverage and Medicaid work together.
  • Verify and update ongoing eligibility so families do not lose coverage.
  • Help patients resolve insurance issues as they arise.
  • Manage referrals and patient records in PFA's customer relationship management system.
  • Upload, scan, and securely transmit documentation.
  • Document every patient interaction in accordance with HIPAA and internal compliance standards.
  • Use an iPad and iPhone throughout the day.
  • Represent PFA on-site as the primary contact for hospital staff.
  • Build working relationships with case managers, social workers, financial counselors, state agency contacts, and community partners.
  • Meet weekly and monthly targets for patient contacts, screening, applications, conversion, submission timing, documentation accuracy, compliance, and eligibility renewals.
Desired Qualifications
  • 3 to 5 years of experience in patient-facing roles in a hospital or health system.
  • Working knowledge of Medicaid and Medicare eligibility, employer-sponsored coverage, and coordination of benefits.
  • Direct Health Insurance Premium Payment or premium assistance experience, or experience with an eligibility and enrollment vendor.
  • Background in patient access, patient financial services, financial counseling, health plan member services, or benefits enrollment.
  • Full bilingual proficiency in Spanish.
  • An Associate's or Bachelor's degree in Social Work, Healthcare Administration, Public Health, or a related field.
  • Training in motivational interviewing, trauma-informed care, or medical billing and coding.
  • Ability to read and interpret an explanation of benefits, benefits summary, or medical bill.

About the company

P

Patient Funding Alternatives

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PFA helps hospitals enroll eligible Medicaid patients into Health Insurance Premium Payment programs to gain access to employer-sponsored or COBRA commercial insurance, with Medicaid as a secondary payer. It uses a national web-based platform with algorithms to identify eligible patients and Patient Advocate Specialists to guide enrollment and provide ongoing support. They differentiate themselves by partnering with hospitals nationwide (including academic medical centers and children's hospitals) and delivering incremental revenue to partners by converting Medicaid patients to higher-reimbursement commercial plans, backed by private equity. Their goal is to expand access to broader insurance networks and care management for patients while improving hospital payer mix and health equity.

Company Size

51-200

Company Stage

N/A

Total Funding

N/A

Headquarters

Woburn, Massachusetts

Founded

2012

Get referred to Patient Funding Alternatives

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Simplify Jobs

Simplify's Take

What believers are saying

  • PFA still advertises growing health-system partnerships and national hiring in August 2026.
  • ACA subsidy expiration in 2026 pushes more working Medicaid patients toward employer coverage conversion.
  • Hospital margin pressure remains severe; PFA's premium-assistance model directly monetizes reimbursement gaps.

What critics are saying

  • Georgia Medicaid upgraded HIPP online renewals in 2026, shrinking PFA's process advantage.
  • Hospitals face growing pushback against profit-driven patient steering, threatening contract renewals by 2027.
  • Any state HIPP rule tightening would immediately cut PFA conversions and hospital revenue.

What makes Patient Funding Alternatives unique

  • PFA uniquely specializes in hospital-embedded HIPP enrollment across 39 states, per 2026 site.
  • Its Patient Advocate Specialists handle administration, leaving hospitals minimal operational burden, per August 2026 site.
  • PFA claims $279 million incremental hospital revenue over eight years, anchoring ROI-driven differentiation.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • 401(k) Retirement Plan
  • 401(k) Company Match
  • Health Savings Account/Flexible Spending Account
  • Wellness Program
  • Mental Health Support
  • Remote Work Options