Patient Advocate Career Guide
How to Become a Patient Advocate
If you have an interest in navigating insurance claims, dealing with medical billing, and communicating with healthcare professionals, you may be the perfect fit for a career in patient advocacy. These processes are often overwhelming for patients—especially while patients are dealing with sickness or disease—and patient advocates are available for help in these situations.
What Is a Patient Advocate?
Patient advocates work with healthcare patients on their behalf. Patient advocates work alongside insurance companies and healthcare workers to ensure that their clients make the best information-based decisions regarding their health. They work in several different roles as well. Some patient advocates specialize in one particular area such as insurance, medical literacy, or other high-need areas while others provide multiple advocacy services. Largely, a patient advocate serves as the liaison between patients, healthcare staff, and insurance companies.
What Does a Patient Advocate Do?
As mentioned above, the role of one patient advocate may vary greatly from the role of another. One patient advocate may focus their services entirely on nursing advocacy while others may provide advocacy services in a number of areas. The exact day-to-day of a patient advocate will vary greatly depending on the expectations agreed upon between involved parties. Below is a list of different generalized tasks that patient advocates are often responsible for:
- Healthcare visit support: Patient advocates help patients get the most out of their healthcare visits. Caregivers and clinical environments can be intimidating to many patients, and a patient advocate can help by preparing patients beforehand or even attending an appointment with a patient. This helps to ensure that they are getting all of the answers to their questions and that they are asking all of the questions that should be asked.
- Insurance support: Patient advocates often help their patients understand everything that they need to know about their insurance coverage. They will help patients understand what their insurance covers vs. what it doesn’t, premiums, co-pays, payer reimbursements, deductibles, and any other health insurance-related support. They also work with healthcare financial departments to bill their patient's insurance for care.
- Financial support: Patient advocates specialize in healthcare financial support. They work alongside healthcare billing and financial departments to monitor different financial processes like billing the insurance provider, negotiating treatment or care costs, and identifying any medical bill errors. They also help patients understand treatment costs, payment plans, and what is covered by insurance vs. out-of-pocket costs. They can also help patients locate different financial support programs and organizations that help offset the cost of healthcare.
- Healthcare literacy: Doctors are busy and may accidentally skip over certain pieces of information that they think are common knowledge or understood (for example, the severity of a diagnosis). Patient advocates can help by making sure that both patients and their loved ones understand the diagnosis, prognosis, treatment options, costs, and any other information that may not be clear after a visit.
- Patient rights: Patient advocates help their clients navigate their rights as a patient to ensure that healthcare workers and insurers are providing proper care according to the book. They will help patients understand both local and federal patient rights laws. Patient advocates can help identify any care gaps or concerns and make suggestions or take action accordingly—in some cases they may help with seeking out legal representation. Some scenarios that may require a patient advocate to include do not resuscitate orders (DNR) or refusal of services.
Where Does a Patient Advocate Work?
Patient advocates are not limited to one work setting; there are numerous places where they can work. Below is a list of different settings where a patient advocate can potentially work:
- Insurance companies: There are insurance companies that employ advocates to help patients with difficult medical cases. They help patients save money and navigate any difficulties that arise throughout the insurance claim process.
- Government agencies: There are government entities that employ advocates to work with patients that rely on state-run programs like Medicare and Medicaid. They help patients get the most out of the program they are involved with.
- Patient-focused firms: There are private firms that employ patient advocates. Both for-profit and nonprofit organizations specialize in healthcare, insurance, and treatment advocacy. These types of advocates are generally hired indirectly by a patient or a family member of a patient.
- Private patient advocate: You can work as a private patient advocate as a self-employed entrepreneur. These types of advocates are generally hired directly by a patient or a family member of a patient. Note that if you choose to go this route, you are not only responsible for patient advocacy, but also marketing your services, bringing in clients, and running a business.
How Do I Become a Patient Advocate?
The route to becoming a patient advocate isn’t as uniformly defined as other certified or licensed careers like becoming a nurse or teacher. Many careers—especially healthcare careers—require some combination of formal education and certification, but as is, there are no national or state standards required for patient advocates. However, just because there aren’t any definitive universal standards doesn’t mean that you automatically have the credentials to become a patient advocate. Below are some methods for obtaining the necessary skills for a career as a patient advocate.
What Education Does a Patient Advocate Need?
Although there are no formal education requirements necessary for a career in patient advocacy, there are several degree programs that can help you get the relevant healthcare experience necessary for success in the role. Some examples of degree programs that translate well into patient advocacy include:
- Social work
- Health services coordination
- Nursing
- Healthcare management
- Health information management
There are also online degree programs that are designed to be flexible to help working individuals attend school. Additional schooling can help you stand out to employers, so consider taking advantage of master’s programs like an MBA in healthcare management or an MSN in leadership and management.
Best Degrees for Patient Advocates
Nursing (Prelicensure) – B.S.
A one-of-a-kind nursing program that prepares you to be an RN...
A one-of-a-kind nursing program that prepares you...
A one-of-a-kind nursing program that prepares you to be an RN and a baccalaureate-prepared nurse:
- Locations: offered in FL, IN, TX, and UT only.
- Tuition and fees: $6,575 per 6-month term.
WGU offers the prelicensure program in areas where we have partnerships with healthcare employers to provide practice sites and clinical coaches to help teach you and inspire you on your path to becoming a nurse.
If you don't live in one of our prelicensure states or don't qualify to apply, consider getting our Bachelor's Degree in Health Services Coordination instead. This degree allows you to work inside the healthcare industry, while also working directly with patients who need help.
College of Health Professions
Health Services Coordination – B.S.
An online health degree program for students passionate about...
An online health degree program for students...
An online health degree program for students passionate about value-based care and dedicated to helping others.
- Time: 60% of graduates of similar programs finish within 3 years.
- Tuition and fees: $3,795 per 6-month term, plus a Health Professions Student Fee of $350.
Sample careers and jobs this degree will prepare you for:
- Care coordinator
- Patient advocate
- Health services coordinator
- Patient educator
- Community health educator
This degree allows you to work inside the healthcare industry, while also directly working with patients who need help.
College of Health Professions
Nursing – Leadership and Management (BSN-to-MSN) – M.S.
For registered nurses with a bachelor's degree who are ready for...
For registered nurses with a bachelor's degree...
For registered nurses with a bachelor's degree who are ready for greater responsibility:
- Time: 82% of grads finish within 24 months.
- Tuition and fees: $4,385 per 6-month term, plus a Health Professions Student Fee of $350.
Sample careers and jobs this degree program will prepare you for:
- Director of Nursing
Chief Nursing Officer
Quality Director
Clinical Nurse Leader
Project Manager
The Bureau of Labor Statistics projects employment of medical and health services managers to grow 17% by 2024, much faster than the average for all occupations.
Compare degrees
This program is not the only degree WGU offers designed to create leaders in the field of healthcare. Compare our health leadership degrees by clicking the button below.
College of Health Professions
Nursing (RN-to-BSN Online) – B.S.
An online BSN degree program for registered nurses (RNs) seeking...
An online BSN degree program for registered...
An online BSN degree program for registered nurses (RNs) seeking the added theoretical depth, employability, and respect that a bachelor's degree brings:
- Time: 66% of graduates finish within 18 months.
- Tuition and Fees: $3,795 per 6-month term, plus a Health Professions Student Fee of $350.
- Transfers: On average, students transfer 81 credits.
With over 35,000 BSN alumni, this is one of WGU's most popular online degree programs. View our RN to BSN degree guide.
If you don't currently have an RN and don't qualify for your nursing prelicensure program, consider getting our Bachelor's Degree in Health Services Coordination instead. This degree allows you to work inside the healthcare industry in a unique way.
College of Health Professions
Nursing – Leadership and Management (RN-to-MSN) – M.S.
This program for RNs includes a BSN component and is a...
This program for RNs includes a BSN component and...
This program for RNs includes a BSN component and is a substantial leap toward becoming a nurse leader.
- Time: 75% of RN-to-MSN grads finish within 42 months.
- Tuition and fees: $3,795 per 6-month term during undergraduate portion, $4,385 per 6-month term during graduate portion, plus a Health Professions Student Fee of $350.
Some careers and jobs this degree will prepare you for:
- Director of Nursing
Chief Nursing Officer
Quality Director
Clinical Nurse Leader
Project Manager
If you're driven to lead, this online nursing degree will provide you everything needed to make that career a reality.
Compare degrees
This program is not the only degree WGU offers designed to create leaders in the field of healthcare. Compare our health leadership degrees by clicking the button below.
College of Health Professions
Our Online University Degree Programs Start on the First of Every Month, All Year Long
No need to wait for spring or fall semester. It's back-to-school time at WGU year-round. Get started by talking to an Enrollment Counselor today, and you'll be on your way to realizing your dream of a bachelor's or master's degree—sooner than you might think!
What Skills Does a Patient Advocate Need?
If you are working towards a career in patient advocacy, there are some skills that you should have currently or should work towards. The exact skills needed to be effective within the role can vary depending on the nature and specific responsibilities of the role, but the following are some general skills that are indicative of a successful patient advocate:
- Advocacy skills: Advocacy skills are an obvious necessity. You need to be able to effectively communicate, negotiate, plan, research, and act in the best interest of an individual patient or multiple patients.
- Communication skills: You need to have both strong verbal and written communication. You need to take complex healthcare information (insurance forms, medical diagnoses, treatment plans, etc.) and put it into terms that are easily understood by your patients. An effective patient advocate should also be skilled in reading non-verbal cues such as confusion, anger, frustration, or being overwhelmed.
- Interpersonal skills: Patient advocates are in constant communication with patients, healthcare professionals, and insurance companies. To nurture those relationships and collaborate successfully, you need to have important interpersonal skills like positivity, listening skills, and empathy. It’s also important to be able to read social cues so that you can better align with the expectations of the parties involved in your role.
- Negotiation skills: Effective advocating requires a great deal of negotiation. You will need both written and oral negotiation skills to create a solid case for the patients that you advocate for.
- Problem-solving skills: Medical-related decisions and processes are not always straightforward for everyone. Patients may need help with insurance denials or disputes, billing issues, miscommunications, or misunderstandings that create the need for problem-solving skills.
- Attention to detail: A primary aspect of patient advocacy is reading through all of the documentation and making sure that all information is accurate and complete. Successful patient advocates should be able to identify any errors and take action accordingly—especially since proper documentation is so critical for quality care.
- Organizational skills: When you advocate on behalf of someone else, it is important to keep everything in order. Patient advocates often advocate for multiple patients, so it is important to be able to keep each respective patients’ files organized and free of clutter. This role requires both mental and physical organization.
- Financial skills: Another primary aspect of patient advocacy surrounds finances. You will need to be able to make financial recommendations, understand different financial assistance programs (local, state, and federal programs), and you need to be able to answer specific financial questions that may arise at any point.
- Caregiver skills: Patient advocacy requires a combination of empathy and some comfort and familiarity with the modern healthcare system. This makes it particularly helpful for advocates to have some experience working as caregivers—especially doctors or nurses—to help prepare them for guiding patients through the system. Caregivers often require many of the same skills as patient advocates, including problem-solving, communication, organizational, and interpersonal skills—in addition to clinical training and knowledge.
How Much Do Patient Advocates Make?
$63,422
The average United States patient advocate salary comes out to $63,422 with the bottom 10% making $46,380 or under, and the top 10% making $82,777 or above. The amount you make can vary greatly depending on on your education, certifications, relevant skills, experience, geographical location, and where you work (advocacy firm, freelance, etc.).
Are Patient Advocates in Demand?
Yes
The field of patient advocacy is growing as it is becoming more common to employ patient advocates as a part of a care team. Since patient advocacy is relatively new, and one career in patient advocacy can look entirely different from another, there isn’t much definitive information on career outlook
Do I Need Certification to Be a Patient Advocate?
No
Much like the education requirements, there are no formal certification requirements for a career as a patient advocate—but this profession is evolving toward setting more formal standards. The Patient Advocate Certification Board (PACB) created the Board Certified Patient Advocacy (BCPA) certification program in 2018 to help promote competency and professionalism in the patient advocacy field. To receive certification, applicants must sit and pass the three-hour, 150-question exam. You must meet the following eligibility requirements to sit the BCPA exam:
Complete a self-assessment readiness survey online;
Submit two letters of recommendation;
Possess a bachelor’s degree (or higher) OR possess relevant experience with proof.