Member Care Advocate

Ametros Financial is a collaboration of insurance and healthcare professionals with a vision to revolutionize how medical care and healthcare payment processing is coordinated for patients, insurance payors, and providers with cutting edge technology, continuous innovation, and world class service enabling those seeking care to live happier, healthier, and more productive lives. Our depth of expertise in the insurance, healthcare, financial services and software industries has positioned us to develop the best product in the marketplace for managing medical treatment, ensuring regulatory compliance, and solving complex billing and payment issues in the healthcare world. Our patented card and systems allow injured workers (our Members) to receive medical treatment seamlessly and gain access to cutting-edge billing support, while remaining in compliance with Medicare and other regulatory requirements. The Ametros team is made up of critical-thinkers, innovators and ambitious professionals who are driven towards success by leveraging innovative approaches and technology in the insurance and healthcare services sectors. Ametros Financial offers a competitive benefits package that includes medical and dental insurance, as well as paid vacation time. Job Description The Opportunity: We are seeking a Member Care Specialist to primarily ensure that our members are delivered a concierge‑class of service. This includes professionally and compassionately answering member questions and concerns, troubleshooting online account problems, and monitoring pharmacy claims. The position requires excellent telephone etiquette and email communication skills. Our company is extremely passionate and dedicated to providing superior service. If you thrive in a fast‑paced innovative environment that emphasizes individual accountability with the support of a team structure, come join us! Your Day‑to‑Day: Manage member inquires via email and incoming & outbound calls Identify and assess members needs to achieve customer satisfaction Explain the product and service as it relates to billing and medical authorization to various parties by both phone and email Assist members navigate our online website and their online web portal Process Durable Medical Equipment requests Process receipts for reimbursement Assist with locating providers, transportation, pharmacies and setting up appointments for members Participate in ongoing training to enhance job skills and knowledge Act in compliance with security and HIPAA policies and procedures Participate in a rotating, weekend overtime shift to ensure optimal member support Qualifications What you bring to the team: Bachelor’s Degree or equivalent professional experience in a Customer Service related role 1‑3 years of experience in a fast‑paced customer care focused role with proven results 1‑3 years of experience in a call center environment with proven multi‑tasking abilities Strong work ethic, attention to detail, and empathy toward members on our platform Proven ability to research and resolve complex customer issues, including de‑escalation experience Proven track record of dependability and professionalism Skills and experiences that will set you apart: 1‑3 years of Medical Claims terminology – ICD‑10, CPT, HCPCS Knowledge of Medicare guidelines and state fee schedules in correlation to Worker’s Compensation 1‑3 years of medical case management experience Bilingual in English and Spanish Additional Information Why Ametros? To make a thriving company culture, you need an identity. You need hard DNA, not just fluff. Our DNA is rooted in providing timely, effective and empathetic assistance to those who need it most. Come be part of a team that not only believes in doing this but is obsessed with it! The Ametros culture provides both an exciting and rewarding place to grow your career while making a difference to those we call members. You will be encouraged from day one to be a vital piece of our puzzle to revolutionize the healthcare industry. Our employee’s actions are guided by the five simple concepts of the Ametros “Words we Work by” Agile, Collaborative, Innovative, Passionate, and Committed. We offer a comprehensive benefits package including: Medical, dental, vision, supplemental plans, and flexible spending accounts Generous paid time‑off and holidays Company Paid Short‑term disability, Long‑term disability and Life Insurance plans Common Sense Casual Dress Code Located just outside of Boston, our home office is located in Wilmington, MA and easily accessible from multiple routes unlike traveling in the Boston traffic Our home office has building amenities such as a cafeteria that serves breakfast and lunch as well as multiple fitness areas free to you as an Ametros Employee Working for Ametros, you can go home at night feeling good about what you do every day. Whether it is working directly with our members, educating our clients or providing support to our team; you will be part of something bigger to help our members live happier, healthier and more productive lives. Ametros is an Equal Opportunity Employer Job Location #J-18808-Ljbffr