Senior Member Care Specialist

Ametros Financial Corporation - Wilmington, MA3.8

Full-timeEstimated: $41,000 - $59,000 a year
The Opportunity:
We are seeking a Senior 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 incoming calls, email and chat within established turnaround times
  • Assist member with locating providers, transportation, pharmacies and setting up appointments
  • Work closely with our members to manage and analyze their financial transactions to ensure they stay compliant with Medicare and other regulatory requirements.
  • Identify and resolve members needs to achieve the ultimate customer experience
  • Monitor and resolve pharmacy rejected claims within the established turnaround times
  • Support and troubleshoot member issues with our online member portal
  • Listen to member or client service problems by determining the cause of the problem and identify the best solution for resolution
  • Maintain customer accounts by updating account information when applicable
  • Document all communication, upload appropriate documents to internal database, and document clear concise notes in our database to ensure accounts are up-to-date
  • Process member reimbursements in compliance with Medicare and regulatory requirements
  • Support team lead with training materials and rollout of training for new employees.
  • Support lead with consistency of training on the team.
  • Act as a resource for Member Care Coordinators.
  • Act as a backup to Team Lead
  • Participate in ongoing training to enhance job skills and knowledge
  • Other duties as assigned.
What you bring to the team:
  • Bachelor’s Degree or equivalent professional experience in a Customer Service related role
  • 5-7 years of experience in a fast-paced customer care focused role with proven results
  • 5-7 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:
  • Knowledge of Medicare guidelines and state fee schedules in correlation to Worker’s Compensation
  • 3+ years of medical case management experience
  • Bilingual in English and Spanish
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
  • 401 (k) plan
  • 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
Interested candidates should apply directly through our career page at