Patient Advocate - Billing and Benefits

Responsibilities

• Review patient-submitted EOBs, itemized receipts, and billing statements for red flags, including upcoding, balance billing, incorrect benefit application, and other discrepancies
• Analyze health plan documents, such as Summary Plan Descriptions (SPDs), to verify proper benefit application and compliance
• Act as a third-party advocate by contacting healthcare facilities to request rebills, correct information, or resolve errors
• Follow up with insurance providers to confirm accurate processing and address any insurer-side mistakes
• Communicate clearly and empathetically with patients via messaging to explain findings, next steps, and resolutions
• Document all reviews, communications, and outcomes in our internal systems for compliance and tracking
• Collaborate with internal teams to escalate complex cases involving appeals or persistent issues

Requirements

• Minimum five (5) years experience in a health care setting including medical, insurance, or hospital setting
• Proven experience in medical billing, revenue cycle management, or a related field (e.g., claims processing, patient financial services)
• Familiarity with handling appeals, interpreting EOBs, and applying benefits from various health plans
• Experience reading and analyzing SPDs or similar plan documents
• Strong understanding of common billing errors and healthcare reimbursement processes
• Excellent communication skills, with the ability to explain complex billing concepts to non-experts
• Proficiency in Microsoft Office Suite or similar tools for document review and reporting
• Certification in Medical Billing - preferred

Benefits

• Inclusive, team-driven culture where your voice is valued and collaboration is the norm
• Opportunities to deepen your expertise in patient advocacy, insurance processes, and healthcare operations
• A sense of mission—be part of a team that helps patients find clarity, access, and peace of mind at critical moments
• A comprehensive benefits package that includes medical, dental, and vision coverage, paid time off, and a 401(k) plan

Pay

Pay range for this position is $58,000 - $80,000 annually