Member Financial Services Analyst

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Amae Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

👥 B2C

🧘 Wellness

🔬 Science

B2C • Wellness • Science

Amae Health is a clinical health services organization that delivers precision medicine and integrated, in-person care for people living with complex mental health conditions. The company operates outpatient clinics in multiple U. S. cities and offers multidisciplinary services—psychiatry-led treatment, group therapy (CBT, DBT), family support, integrated nutrition/exercise/sleep management, primary care, mindfulness and holistic health coaching, and peer support—while partnering with academic medical centers to advance research. Amae combines clinical care with data-driven research and administrative/technology support to personalize treatment and scale evidence-driven approaches toward improved outcomes and new discoveries.

📋 Description

• 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