Member Services Specialist

Watershed Ventures; United States; Hybrid; USD 82,000 - 96,000; Full time

Benefits offered by this job

Hybrid work model

Equity and benefits

Job summary

Maven Clinic is seeking a Member Services Specialist to manage complex member cases from first contact through resolution, by phone and in writing. You will handle everyday support volume, including appointment changes, login issues, enrollment questions, and partner programs.

The role requires handling shifts across evenings, weekends, and holidays, with 7-day-a-week support for Maven members. This position emphasizes empathy, accuracy, and timely communication.

Qualifications

• Investigate before responding: review history and provide an informed answer.
• Keep members informed based on timelines, even when resolution takes days or weeks.
• Explain coverage, eligibility, and reimbursement rules clearly and accurately.

Responsibilities

• Own complex and sensitive cases end to end, including appeals, denied claims, and coverage changes.
• Take member calls on specialty workflows and manage conversations that may have gone badly.
• Read and interpret what a member is asking for; distinguish denial vs. appeals and handle accordingly.
• Investigate before replying and pull history to craft a concrete answer.
• Keep members updated on their timeline and next steps.

Skills

Investigate before responding

Keep members informed

Explain coverage and reimbursement

Drive cases through resolution

Handoffs with context

Shift work experience

Identify recurring issues

Customer empathy

Tools

Zendesk

Jira

Slack

Job description

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:

• TIME 100 Most Influential Companies (2023, 2026)
• 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)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)

About the Role:

Maven is looking for a Member Services Specialist to take on our most complex and sensitive member cases.

A few examples: a member’s reimbursement is denied and she wants it reviewed again mid-IVF cycle, while her clinic is asking for payment. Her Wallet card declines at the pharmacy, leaving her $900 out of pocket. Her employer changes plans two weeks before a scheduled transfer. Each case involves money, medical timelines, and a high level of trust.

You’ll own cases like these from first contact through resolution, by phone and in writing. You’ll also handle everyday support volume, including appointment changes, login issues, enrollment questions, and partner programs. The mix shifts with demand, so breadth matters as much as depth.

Our Member Services team supports Maven members 7 days a week. The shifts we’re hiring for are listed below in EST.

• Monday–Friday, 8:30 a.m.–5:00 p.m.
• Monday–Friday, 10:00 a.m.–6:30 p.m.
• Monday–Friday, 1:00 p.m.–9:30 p.m.
• Tuesday–Saturday, 8:30 a.m.–5:00 p.m. weekdays; 9:00 a.m.–5:30 p.m. Saturday
• Tuesday–Saturday, 10:00 a.m.–6:30 p.m. weekdays; 9:00 a.m.–5:30 p.m. Saturday
• Tuesday–Saturday, 1:00 p.m.–9:30 p.m. weekdays; 9:00 a.m.–5:30 p.m. Saturday
• Sunday–Thursday, 8:30 a.m.–5:00 p.m. weekdays; 9:00 a.m.–5:30 p.m. Sunday
• Sunday–Thursday, 1:00 p.m.–9:30 p.m. weekdays; 9:0 a.m.–5:30 p.m. Sunday

What You’ll Do:

• Own complex and sensitive cases end to end, including appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, and urgent care needs.
• Take member calls on specialty workflows, including conversations that have already gone badly.
• Understand what a member is actually asking for and apply the right workflow—knowing, for example, that a denial question and a formal appeal may require different handling.
• Owning complex and sensitive cases end to end, including appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, and urgent care needs
• Taking member phone calls on specialty workflows, including the conversations that have already gone badly
• Reading what a member is actually asking for. A question about a denial and a formal appeal look alike and are handled differently. So do a denied application and a denied claim
• Investigating before you reply. Pull the history, find where it broke, and come back with an answer instead of a status update
• Keeping members updated on their timeline rather than ours when a case takes days or weeks
• Explaining coverage, eligibility, and reimbursement rules in language a member can act on, without promising an outcome you do not control
• Driving cases that need Jira, Compliance, a clinic, or a benefits administrator to finish, and staying on them until they do
• Knowing what is yours to solve and what needs to move, and handing off with enough context that nobody restarts your work
• Carrying general support volume alongside the complex work as demand shifts across programs and channels
• Noticing what members keep running into, and bringing it to your manager with a fix in mind
• Working your assigned shift, including evenings, overnights, weekends, and holidays

What You’ll Bring:

• Investigate before responding: review the history, identify where an issue broke down, and provide an answer rather than a status update.
• Keep members informed based on their timeline, especially when resolution takes days or weeks.
• Explain coverage, eligibility, and reimbursement rules clearly and accurately, without promising outcomes you don’t control.
• Drive cases requiring Jira, Compliance, clinics, or benefits administrators through resolution and follow through until they’re closed.
• Know what you can solve independently, what needs to be escalated, and how to hand off with enough context that work doesn’t start over.
• Balance complex escalations with general support volume as demand shifts across programs and channels.
• Identify recurring member issues and bring forward practical solutions to improve the experience.
• Work your assigned shift, including evenings, overnights, weekends, and holidays, as applicable.

Nice to Have:

• Experience with claims, appeals, reimbursement, or payments.
• Experience with fertility benefits, specialty healthcare, or financial operations.
• Experience with Zendesk, Jira, and Slack.
• Experience mentoring peers or supporting QA programs.
• Spanish fluency, written and verbal.

The base salary range for this role is $82,000 - $96,000 per year. You will also be entitled to receive equity 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 and inclusive work environment. This role is open to candidate in: AZ, DC, DE, FL, GA, HI, IL, KS, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OR, PA, SC, TN, TX, VA, VT, WI. Maven is committed to supporting remote team members with the tools and collaborative culture needed to thrive regardless of location. This policy reflects our belief that great work can happen anywhere and that flexibility enables our team to do their best work.

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 [e-mail]).

Please contact us at [e-mail].