Senior Payment Operations Specialist — Hybrid (RCM)

Maven Clinic; Texas; Hybrid; USD 98.000 - 115.000; Vollzeit

Benefits dieser Stelle

Stock options

Hybrid work model

Parental leave

Professional development stipend

Career coaching

401K matching

Zusammenfassung

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.

Qualifikationen

• 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

Aufgaben

• 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

Kenntnisse

Benefits management

Process design

Cross-functional collaboration

Data storytelling

Claims software

MS Office

Independence & teamwork

Ausbildung

Bachelor’s degree (preferred)

Tools

Availity

Stedi

Jobbeschreibung

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.