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Amynta Group

Warranty and specialty risk underwriters

Member Services Manager

Customer SupportPosted on Nov 13
Full-timeNew Jersey, USA$115k - $125k /yr

About the Job

Requirements

  • At least 5 years of experience in health advocacy, care navigation, health plan member services, benefits administration, or medical billing, including at least 2 years leading a team.
  • Deep knowledge of employer health benefits, including medical, pharmacy, dental, vision, HSAs, FSAs, HRAs, life, disability, and voluntary benefits.
  • Working knowledge of claims, EOBs, prior authorizations, denials and appeals, and medical billing.
  • A track record of coaching people to deliver high-quality service, including call monitoring and quality programs.
  • Experience managing to service level agreements and metrics such as CSAT, NPS, response times, and resolution times.
  • Sound judgment in escalated and sensitive situations.
  • Written and verbal communication with members and team members.
  • Comfort working in a fast-growing startup environment.
  • Understanding of HIPAA and protection of members’ health information.
  • Bachelor’s degree.

Responsibilities

  • Assist with hiring, onboard, and lead Care Guides and Billing Guides, build team culture, and continue developing the team as new clients are added.
  • Train new Guides using the company’s training program and resources, oversee their certification, and keep training current as benefits, laws, and clients change.
  • Hold regular one-on-ones, set goals, write development plans, and recognize strong work.
  • Address performance concerns fairly and promptly.
  • Ensure Guides consistently deliver the company’s intended member experience.
  • Review recorded and live calls, emails, and portal messages; coach in the moment; and lead calibration sessions so quality is scored consistently.
  • Audit calls, emails, portal messages, and cases from first contact through resolution for content, sentiment, accuracy, SLA adherence, and compliance, and use findings for coaching.
  • Oversee escalations, including complaints and sensitive situations, and personally handle complex cases.
  • Lead regular reviews of cases and member interactions to ensure Guides follow standards.
  • Ensure the crisis protocol, HIPAA practices, and scope boundaries are followed.
  • Manage staffing and schedules to cover service hours, including rotating evening shifts and remote Fridays.
  • Monitor queues, case aging, and workloads in real time, and adjust resources as needed.
  • Ensure the team meets service level agreements and performance guarantees for response time, resolution time, and member satisfaction.
  • Lead daily huddles and ensure smooth, complete handoffs between Care Guides and Billing Guides.
  • Ensure the team follows workflows and work with the Chief Client Officer on process improvements, gaps, and feedback.
  • Own the member services scorecard, including timeliness, quality, member satisfaction, Net Promoter Score, and impact measures such as savings, billing corrections, and appeals won.
  • Prepare reporting and insights for the Chief Client Officer.
  • Identify trends in member requests, carrier problems, and billing errors, and recommend fixes.
  • Share member feedback with the Chief Client Officer to improve technology and services.

Desired Qualifications

  • Experience launching or scaling a member services or advocacy team.
  • Experience working in the health insurance space.
  • Experience with self-funded plans, reference-based pricing, PBMs, and point solutions.
  • Knowledge of the No Surprises Act, state balance billing laws, and ERISA claims and appeals rules.
  • Experience with case management, CRM, and call center systems, including call recording and quality tools.
  • A medical billing or coding certification, or a health care advocacy credential.
  • Bilingual ability in English and Spanish.

About the Company

Amynta Group

Warranty and specialty risk underwriters

Amynta Group coordinates warranty and service contracts for automotive, consumer products, and specialty equipment, and administers niche workers’ compensation and contractor liability coverage in the US and Canada through multiple carrier partners. Its products are implemented by underwriting with carriers and administering programs via a network of MGAs, service providers, and risk specialists, covering design, underwriting, administration, and claims management. The company differentiates itself with a broad, multi-carrier platform and deep, industry-focused expertise across a wide administrative network. Its goal is to help clients manage post-sale risk and regulatory compliance by delivering reliable warranty, service contracts, and niche insurance programs through a distributed partner ecosystem.

Company size
201-500
Company stage
Not listed
Total funding
Not listed
Headquarters
New York City, New York
Founded
2018

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