Senior Member Services Specialist — Remote Complex Claims

NextGen; New York (NY); Remote; USD 82,000 - 96,000; Full time

Benefits offered by this job

Hybrid/Remote-Work flexibility

16 weeks paid parental leave

401K matching

Job summary

Maven Clinic is seeking a Senior Member Services Specialist to manage highly complex member cases, including appeals, denied claims and enrollment issues. You will handle daily support tasks such as appointments, logins, and program questions, while maintaining a high standard of care and timely communication.

You’ll work with a team supporting Maven members 7 days a week across various shifts, including evenings and weekends.

Qualifications

• Experience with claims, appeals, reimbursement, or payments.
• Experience with fertility benefits, specialty healthcare, or financial operations.
• Spanish fluency, written and verbal.
• Active US work authorization required.

Responsibilities

• Own complex and sensitive cases end to end, including appeals, denied claims and applications.
• Take member calls on specialty workflows.
• Explain coverage, eligibility, and reimbursement rules clearly.
• Carry general support volume alongside the complex work.

Skills

Spanish fluency

Zendesk

Jira

Slack

Tools

Zendesk

Jira

Slack

Job description

Maven Clinic is seeking a Senior Member Services Specialist to manage highly complex member cases, including appeals, denied claims and enrollment issues. You will handle daily support tasks such as appointments, logins, and program questions, while maintaining a high standard of care and timely communication.

You’ll work with a team supporting Maven members 7 days a week across various shifts, including evenings and weekends.