Role Overview

Own and manage the member-facing phone line and email, delivering compassionate, timely, and solutions-oriented support
Review and educate members on Verifications of Benefits (VOBs) so they can access care without delay
Member Financial Advocacy & Education: Serve as the primary contact for members and families on benefits, authorization status, financial responsibility, payment options, and financial assistance, including self-pay cost breakdowns and de-escalating coverage concerns
Authorization Management: Track prior authorizations and proactively communicate outcomes (approved date ranges, units/days, expirations, next steps) partnering with clinical, UM, enrollment, and RCM teams
Financial Assistance Program (FAP) Administration: Support the Financial Assistance Program end to end (intake, documentation, tracking, and communicating determinations) alongside senior MFS staff
Uninsured Member & Coverage Management: Own the Uninsured Member Tracker: outreach on lapsed/terminated coverage, evaluate alternatives (plan transitions, self-pay, FAP, discharge planning), and reconcile coverage data across systems
Cross-Functional Case Management: Coordinate insurance, billing, and continuity-of-care cases across departments, escalating complex or sensitive situations to senior MFS staff
Payer Portal & Eligibility: Verify coverage, authorization requirements, and network participation through payer portals across commercial, Medicare, Medicaid, and state-specific rules in all Amae markets
Monthly Statement Review: Prepare and review monthly patient statements, audit self-pay balances, and resolve billing discrepancies in line with billing and privacy policies
Ticketing & Documentation: Document and manage MFS workflows in CRM, keeping timely, accurate case records across Foundry, Canvas, Candid, and Drive
Process Improvement: Surface recurring member pain points and workflow improvements to the MFS team

Requirements

2–3+ years of experience working within insurance benefits, billing procedures, and prior authorization processes. SMI/behavioral health experience preferred.
Experience using commercial insurance payer portals required; Medicare and Medicaid experience highly preferred.
Experience in an externally facing role, ideally working directly with patients; comfort with phone-based work required.
Strong communicator who can translate complex payer or process issues into clear action steps across teams.
High EQ and service orientation — you build trust quickly with colleagues, partners, and members.
Adaptable and resilient; you thrive in fast-moving, ambiguous environments.
Organized and detail-driven; you can manage multi-step processes without dropping details.
Familiarity with CRM systems, EMR platforms, and operational documentation practices.
Ability and comfort operating on Pacific Time

Benefits

comprehensive medical/dental/vision
unlimited PTO
parental leave
programs built around employee well-being

Amae Health

Open Positions (1)

Finance

Member Financial Services Analyst