Payment Operations Associate

Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Recognized for innovation and industry leadership, Maven has been named to the Time 100 Most Influential Companies, CNBC Disruptor 50, Fast Company Most Innovative Companies, and FORTUNE Best Places to Work. Founded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. To learn more about Maven, visit us 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)TIME 100 Most Influential Companies (2023)Fast Company Most Innovative Companies (2020, 2023)Built In Best Places to Work (2023)Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)Great Place to Work certified (2020, 2021, 2022, 2023, 2024)Fast Company Best Workplaces for Innovators (2022)Built In LGBTQIA+ Advocacy Award (2022)Maven is looking for a Payment Operations Associate who will be a critical member of the Payment Delivery team focused on ensuring that members are supported during their fertility journeys, especially when it comes to reducing the financial anxiety associated with fertility treatments. This person will play a critical role in managing claim denial and appeals with payers, and resolving discrepancies for members. This role will be reporting to the Director of Payment Operations. As a Payment Operations Associate at Maven, you will:Review and process complex claims related to Maven’s fertility treatments, procedures and applicable medications, and expenses related to additional paths to parenthood in accordance with company policies and benefits plan designs Review claims to identify instances of denials and under paymentsPrepare and submit timely, well-documented appeals and reconsiderations to insurance payers for expedited re-processing of claimsCommunicate with insurance representatives to follow up on appeals and resolve claim issuesMaintain accurate records of appeals, claim statuses, and outcomesFacilitate timely and accurate payments and resolve payment disputes Identify patterns or trends in denials and escalate systemic issues to managementWork with other departments to ensure a smooth and efficient payment process across all stakeholdersWe’re looking for you to bring: 2-4 years of experience in benefits management or insurance focusing on claims and collections Understand medical billing, coding, insurance claims processing, and revenue cycle management (fertility claims experience is a plus)Excellent communication skills; this includes written and spoken communicationProficient in using relevant software and tools for claims and collection management (Availity, Stedi, etc.)Proficient in Microsoft Office tools 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 plusFor candidates in NYC, CO, or CA, the base salary range for this role is $80,000-$85,000 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. Maven embraces a flexible hybrid work model. Our teams primarily operate from the New York Metropolitan area, NY, 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.This role requires active work authorization in the US.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 YouOur 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 partnershipsHybrid 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 Mavens401K matching for US-based employees, with immediate vestingThese 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 [email protected]). 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: [email protected]. For general and additional inquiries, please contact us at [email protected]. Originally posted on Himalayas

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