Payment Operations Associate

Maven Clinic is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Through Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women's and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Through its consumer platform, Maven provides direct access to virtual care across 30+ specialties, as well as dedicated hormone and GLP-1 care programs purpose-built for women. Founded in 2014 by CEO Kate Ryder, Maven Clinic has raised more than $425 million from leading healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. Recognized for innovation and industry leadership, Maven has been named to the TIME100 Most Influential Companies, CNBC Disruptor 50, Fast Company's Most Innovative Companies, and FORTUNE Best Places to Work. Learn more at mavenclinic.com An award-winning culture working towards an important mission – Maven Clinic is a recipient of over 30 workplace and innovation awards, including: Fortune Change the World (2024) CNBC Disruptor 50 List (2022, 2023, 2024) Fortune Best Workplaces for Millennials (2024) Fortune Best Workplaces in Health Care (2024) Fast Company Most Innovative Companies (2020, 2023) As an Associate, Payments [RCM] at Maven, you will: Review and process complex claims related to Maven's fertility treatments, procedures, applicable medications, and expenses tied to additional paths to parenthood, in accordance with company policy and benefit plan designs Review claim to Identify instances of denials, underpayments, overpayments Prepare and submit timely, well-documented appeals and reconsiderations to insurance payers for expedited re-processing of claims Communicate directly with insurance representatives to follow up on appeals and resolve claim issues Identify patterns or trends in denials and elevate systemic issues to management Verify member eligibility and benefits ahead of and during claims processing Resolve eligibility discrepancies between payer records and member/benefit plan data Coordinate prior authorizations where applicable to fertility treatment coverage Facilitate timely and accurate payments and resolve payment disputes across payers and claims Post and reconcile payments against expected reimbursement; research underpayments and unapplied cash Work with both internal and external cross-functional stakeholders to ensure a smooth and efficient payment process Maintain and improve SOPs for all Revenue Cycle Management processes We’re looking for you to bring: 2-4 years of experience in revenue cycle management, benefits management, or insurance billing, focused on claims and collections Understanding of medical billing, coding, insurance claims processing, and revenue cycle management (fertility claims experience is a plus) Excellent written and spoken communication skills Proficiency with relevant claims/collections software (Availity, Stedi, or similar) Proficiency in Microsoft Office tools or Google Suite Tools Experience leveraging AI tools to streamline processes and workflows Ability to work independently and as part of a team Strong organizational skills; demonstrated ability to multi-task and manage time effectively Bachelor's degree is a plus The base salary range for this role is $81,000-$95,000 per year. You will also be entitled to receive stock options and benefits. Individual pay decisions are based on a number of factors, including qualifications for the role, experience level, and skillset. This role requires active work authorization in the US. Maven embraces a flexible hybrid work model. Our teams primarily operate from the New York Metropolitan area, NY, and remotely via San Francisco/Bay Area, CA, Seattle, WA, Boston, MA, Chicago, IL, and Washington, D.C. For those in our New York City office, we encourage in-person collaboration by requiring team members to work onsite three days a week (Tuesday, Wednesday, Thursday). For those based in San Francisco/Bay Area, CA, Seattle, WA, Boston, MA, Chicago, IL, and Washington, D.C., we encourage in-person collaboration by requiring team members to attend quarterly Work Together Days within these cities. This policy aims to balance remote work flexibility with the benefits of face-to-face interaction. At Maven we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams. Benefits That Work For You Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits: Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics. Whole-self care through wellness partnerships Hybrid work, in office meals, and work together days 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+) Annual professional development stipend and access to a personal career coach through Maven for Mavens 401K matching for US-based employees, with immediate vesting These benefits are applicable to Maven Clinic Co., US-based, full-time employees only. 1099/Contract Providers are ineligible for these benefits. Maven is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Maven is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Maven Clinic interview requests and job offers only originate from an @mavenclinic.com email address (e.g View email address on click.appcast.io). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: View email address on click.appcast.io . For general and additional inquiries, please contact us at View email address on click.appcast.io . #J-18808-Ljbffr