Payment Operations Senior Associate

Maven Clinic; Texas; Hybride; USD 98 000 - 115 000; Plein temps

Avantages offerts par ce poste

Stock options

Hybrid work model

Parental leave

Professional development stipend

Career coaching

401K matching

Résumé du poste

Maven Clinic is seeking a Senior Associate, Payment Operations to drive revenue-cycle expansion into insurance-based billing. You will manage claim denials and appeals, resolve real-time eligibility errors, and unblock payments, reporting to the Manager, Revenue Cycle Management.

You will develop SOPs for new claim types, review complex claims, and collaborate cross-functionally with Support, Finance and Product to close gaps. A 4–6 year background in RCM is preferred.

Qualifications

• 4-6 years of experience in benefits management, RCM, or insurance claims.
• Experience building or improving operational processes.
• Experience partnering cross-functionally, ideally with support, finance, or product teams.
• Track record of synthesizing operational data into reporting for non-technical or leadership audiences.
• Proficient 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 plus

Responsabilités

• Develop, document, and iteratively refine SOPs for claims processing as new verticals and claim types launch
• Review and process complex claims, maintaining a high first pass clean claims submission rate
• Review claims to identify instances of denials and under payments
• Serve as the point of resolution for cross-functional needs between RCM, Member Support, and Finance on billing issues
• Prepare recurring operational reporting on claims volume, SLA performance, and denial trends for program and leadership review
• Identify and elevate systemic issues, with authority to resolve claims-specific process issues directly, escalating member-experience or product-level issues to the appropriate owner

Connaissances

Benefits management

Process design

Cross-functional collaboration

Data storytelling

Claims software

MS Office

Independence & teamwork

Formation

Bachelor’s degree (preferred)

Outils

Availity

Stedi

Description du poste

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 Senior Associate, Payment Operations to support our program expansion into insurance-based billing. This person will play a critical role in managing claim denial and appeals with payers, resolving real time eligibility system errors, and unblocking payment issues. This role will be reporting to the Manager, Revenue Cycle Management.

What You’ll Do

• Develop, document, and iteratively refine SOPs for claims processing as new verticals and claim types launch
• Review and process complex claims, maintaining a high first pass clean claims submission rate
• Review claims to identify instances of denials and under payments
• Serve as the point of resolution for cross-functional needs between RCM, Member Support, and Finance on billing issues
• Prepare recurring operational reporting on claims volume, SLA performance, and denial trends for program and leadership review
• Identify and elevate systemic issues, with authority to resolve claims-specific process issues directly, escalating member-experience or product-level issues to the appropriate owner

What You’ll Bring

• 4-6 years of experience in benefits management, RCM, or insurance claims, including experience building or improving operational processes
• Comfort operating with ambiguity and building process from scratch, this role is standing up SOPs for a business line that doesn't have them yet, not following an established playbook
• Experience partnering cross-functionally, ideally with support, finance, or product teams, to resolve process gaps
• Track record of synthesizing operational data into reporting for non-technical or leadership audiences
• Proficient 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 plus

The base salary range for this role is $98,000-$115,000 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.