Patient Benefits Eligibility Specialist - Boston Area, MA

Internal Title: Patient Benefits Partner

Who is Gather Health?

Gather Health is a collective of outreach partners, care partners, clinicians, and most importantly, patient partners who work together to reshape lives and communities. We bring hands-on social and medical care to our patients and work around their needs, both within our care facilities and in their homes. We work alongside local leaders to build communities and provide tailored care experiences that serve the seniors that live within them. When we Gather, we show love, compassion, community, and care.

What is a “Patient Benefits Partner”?

A Patient Benefits Partner (PBP) serves as the benefits expert at Gather Health and assists our patients with insurance needs, Medicaid applications, and provides solutions to their questions regarding their benefits options (i.e., Medicare Advantage plans). This person will be responsible for educating existing and prospective patients about various types of benefits including Medicare, Medicare Advantage, Medicaid, and helping them navigate through the application process.  Reporting to the Field Sales Manager, the PBP works as part of our Growth Team.  In addition to assisting our patients with their insurance options and needs, the PBP will partner strategically with external partners such as brokers and payors in an effort to provide the best experiences possible to our patients.      

What are some of the day-to-day duties?  

·         Conducting a benefits orientation during our new patients’ visits to the clinic

·         Assisting patients in the process of contacting their insurance carriers regarding their PCP switches 

·         Educating patients about Medicare Advantage plans and potential benefits, as well as the application process

·         Developing and maintaining strong relationships with Field Marketing Organizations and brokers

·         Connecting existing and prospective patients with brokers to maintain compliance with regulations

·         Helping our existing patients with insurance related questions and paperwork

·         Providing support to patients in their application process with MassHealth and other public assistance resources

·         Assisting patients in resolving issues related to their medical bills inside and outside of Gather Health

·         Supporting the clinical operations team on an as-needed basis with tasks such as scheduling and billing

·         Working closely with our sales team in conducting clinic tours for prospective and new patients

·         Developing trust-based relationships with existing patients with the goal of high patient retention

·         Monitoring, assessing, and providing recurring reports to show patient engagement and retention trends 

How is the pay structured?

This is an Exempt role with a competitive bases alary, full benefits, plus bonus eligibility. 

What are the requirements for this position? 

·         Minimum of one year’s experience in a similar role working with various insurance plans including Medicare, Medicare Advantage, and Medicaid

·         Avaliddriver’s license and the abilitytotravellocallytovariouseventswithaccesstoavehicle

·         ExperiencewithbasicofficetoolssuchasWord,Excel,Outlook,SharePoint, etc.

·         Ability to read and understand written materials such as policy manuals, etc.

·         Ability to collaborate with multiple departments including Providers, clinical, and operations staff

·         Strong organizational and time management skills

·         Excellent verbal and written communication skills

·         Ability to physically commute into an office full time, Monday through Friday from 8am to 5pm

·         Ability to visit patients’ homes for the first several months prior to clinic launch date 

What are the preferred skills or experience?

·        Experience with Salesforce or another CRM(Customer Relationship Management)system

 Bachelor's Degree

·        Sales or account management background

·        Degree in Business, Health Administration, Public Health, or similar field

What are the traits and characteristics of the ideal candidate most likely to succeed?

·        Persistent–does not give up easily when things get tough

·        Resilient– displays toughness and not easily discouraged

·        Motivated– things like metrics and quotas do not intimidate them

·        Friendly–people enjoy their company because of their pleasant personality

·        Outgoing–likes attending events and meeting new people

·        Relatable–naturally makes human connections with their warmth, humor, and demeanor

·        Positive–sees glass as half full vs. empty

·        Organized– manages their time effectively and operates efficiently

·        Reliable–takes responsibilities seriously and expects the same from others

What are the hours for this position?

Monday–Friday, 8am to 5pm.

Why should you join Gather Health?

·        We are a mission-based organization that is passionate about changing the way seniors experience primary care

·        Our business model is unique and on the cutting-edge of the primary care industry

·        Ourleadershipteamiscomprisedofexperiencedindividualswhoarecommittedtocreatingnotonlythebestpatient experience, but also an amazing employee experience for our colleagues

·        Weareintentionallybuildingastrongcompanycultureandprovidingacompassionateandjoyfulwork environment

·        Theorganizationwasconceptualized,founded,andlaunchedbyexperiencedco-founderswithatrackrecordofsuccessinthe healthcare space

·        We offer competitive pay and benefits for our Full-Time colleagues, including:

o   Base pay, plus bonus

o   Paid Time Off

o   Paid Holidays

o   Medical insurance coverage (health, dental, vision) with no waiting period for enrollment

o   Short and Long-Term disability insurance at no cost to you

o   Basic life insurance coverage at no cost to you

o   401K plan

o   Employee Assistance Program at no cost to you

o   Supplemental benefits available for discounted prices(legal services, Aflac, hospital indemnity, accidental death& dismemberment, etc.) 

Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law.