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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.

 



$45,000 - $65,000 a year
Base salary will be determined based on length and scope of experience in the field. Eligible for 10% annual performance bonus.
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$45000K
$65000K

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What You Should Know About Patient Benefits Eligibility Specialist - Boston Area, MA, Gather Health

Meet your next opportunity as a Patient Benefits Eligibility Specialist at Gather Health in Boston, MA! Here at Gather Health, we are a dynamic community-focused organization where our dedicated outreach partners, care partners, clinicians, and most importantly, our patient partners work together to transform lives and uplift communities. Our mission revolves around providing tailored social and medical care that addresses the unique needs of our patients, wherever they may be. As a Patient Benefits Partner, you will be the go-to expert assisting patients with their insurance inquiries and navigating the often-complex world of benefits like Medicare, Medicaid, and insurance applications. From conducting benefits orientations with new patients to maintaining strong connections with brokers and providers, your day-to-day will be filled with meaningful interactions and helping others. Not only will you support our patients through their journeys, but you will also collaborate with our Growth Team to drive patient engagement and retention. We believe in a work environment that fosters compassion and community, making Gather Health not just a workplace, but a place where you can truly make a difference. With competitive pay, benefits, and an amazing company culture, there's never been a better time to join us in reshaping the future of primary care for seniors!

Frequently Asked Questions (FAQs) for Patient Benefits Eligibility Specialist - Boston Area, MA Role at Gather Health
What are the responsibilities of a Patient Benefits Eligibility Specialist at Gather Health?

As a Patient Benefits Eligibility Specialist at Gather Health, your key responsibilities include assisting patients with understanding their insurance options, navigating Medicaid applications, and guiding them through Medicare Advantage plans. You will conduct benefits orientations for new patients, help them resolve billing issues, and connect them with brokers to ensure compliance with regulations. Your role is crucial in supporting a positive patient experience while also collaborating with external partners to boost patient engagement and retention.

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What qualifications are needed for a Patient Benefits Eligibility Specialist at Gather Health?

To thrive as a Patient Benefits Eligibility Specialist at Gather Health, you should have at least one year of experience working with various insurance plans including Medicare, Medicare Advantage, and Medicaid. A valid driver's license for local travel is required, along with proficiency in basic office tools. Strong organizational skills, the ability to read policy manuals, and excellent communication skills are essential for success in this role.

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How does Gather Health support its Patient Benefits Eligibility Specialist?

Gather Health ensures that its Patient Benefits Eligibility Specialists have the resources and support needed to excel in their roles. This includes offering a competitive salary, full benefits package, and a nurturing work environment focused on personal and professional growth. You'll work closely with our Field Sales Manager and collaborate with various departments to provide the best care for our patients.

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What is the work environment like for a Patient Benefits Eligibility Specialist at Gather Health?

At Gather Health, the work environment for the Patient Benefits Eligibility Specialist is collaborative and mission-driven. You will be part of a dedicated team passionate about improving the primary care experience for seniors. With a culture rooted in compassion and community-building, you can expect a supportive atmosphere where your contributions are valued and your personal development is encouraged.

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Are there opportunities for advancement as a Patient Benefits Eligibility Specialist at Gather Health?

Yes, there are ample opportunities for advancement for Patient Benefits Eligibility Specialists at Gather Health. As you build your expertise in the role, you may explore pathways into leadership positions within the organization or specialize further into areas of patient care and insurance. Our leadership team is committed to fostering talent and providing professional growth opportunities.

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Common Interview Questions for Patient Benefits Eligibility Specialist - Boston Area, MA
What experience do you have with Medicare and Medicaid?

When answering this question, highlight your specific experiences working with Medicare and Medicaid, including any direct interactions with patients regarding these programs. Discuss the training you’ve received or certifications obtained, and share any relevant skills you have developed that would contribute to your success as a Patient Benefits Eligibility Specialist at Gather Health.

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How do you handle difficult conversations with patients?

Explain your approach to conflict resolution and communication. Emphasize your ability to empathize with patients’ concerns while remaining clear and professional. You can share an example where you successfully navigated a challenging discussion, demonstrating your skills in providing support and guidance.

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What strategies do you use to manage your time effectively?

Describe your time management techniques, such as prioritizing tasks, planning your day ahead, or using tools like calendars or task lists. Relate this to how you would juggle the various responsibilities of a Patient Benefits Eligibility Specialist at Gather Health, ensuring patients receive timely assistance.

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Can you describe a time when you had to educate someone about a complex benefit issue?

Share a specific instance where you successfully educated a patient or colleague about a complex issue, focusing on how you made the information understandable. Discuss the techniques you used to gauge their understanding and how you adapted your communication style to suit their needs.

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Why do you want to work for Gather Health?

Articulate your alignment with Gather Health’s mission and values. Talk about your passion for improving senior care and how you believe your skills as a Patient Benefits Eligibility Specialist will contribute to the organization’s goals. Personal stories about similar experiences can further enhance your response.

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How would you approach a patient who is hesitant to trust health insurance systems?

Discuss your strategy for building rapport with hesitant patients. Emphasize the importance of empathy, active listening, and providing clear, honest information to alleviate their concerns. Concrete examples of how you have earned trust in similar situations can strengthen your response.

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What do you know about Medicare Advantage plans?

Provide a brief overview of Medicare Advantage plans, including their benefits and potential challenges. Ensure to personalize your response by explaining how this knowledge will help you guide patients in navigating their options effectively at Gather Health.

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How do you stay organized in a fast-paced environment?

Share the tools or methods you use to maintain organization, such as digital management systems or effective prioritization strategies. You could provide examples from previous roles that demonstrate your ability to thrive under pressure while keeping patient needs front and center.

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Describe a situation where you turned a dissatisfied patient into a satisfied one.

Narrate a situation that showcases your customer service skills. Highlight your problem-solving abilities, how you followed up with the patient, and documented the outcome, emphasizing your commitment to patient care and relationships.

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What qualities do you believe are essential for a Patient Benefits Eligibility Specialist?

Discuss essential qualities like empathy, patience, strong communication skills, and an understanding of healthcare systems. Relate these traits back to your personal experiences that illustrate why they are vital in the role at Gather Health.

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SENIORITY LEVEL REQUIREMENT
TEAM SIZE
EMPLOYMENT TYPE
Full-time, on-site
DATE POSTED
March 11, 2025

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