Payment Operations Associate

As an Associate, Payments [RCM] at Maven, you will:

• Review and process complex claims related to Maven's fertility treatments, procedures, applicable medications, and expenses tied to additional paths to parenthood, in accordance with company policy and benefit plan designs
• Review claim to Identify instances of denials, underpayments, overpayments
• Prepare and submit timely, well-documented appeals and reconsiderations to insurance payers for expedited re-processing of claims
• Communicate directly with insurance representatives to follow up on appeals and resolve claim issues
• Identify patterns or trends in denials and escalate systemic issues to management

• Verify member eligibility and benefits ahead of and during claims processing
• Resolve eligibility discrepancies between payer records and member/benefit plan data
• Coordinate prior authorizations where applicable to fertility treatment coverage

• Facilitate timely and accurate payments and resolve payment disputes across payers and claims
• Post and reconcile payments against expected reimbursement; research underpayments and unapplied cash

• Work with both internal and external cross-functional stakeholders to ensure a smooth and efficient payment process
• Maintain and improve SOPs for all Revenue Cycle Management processes

We’re looking for you to bring:

• 2-4 years of experience in revenue cycle management, benefits management, or insurance billing, focused on claims and collections
• Understanding of medical billing, coding, insurance claims processing, and revenue cycle management (fertility claims experience is a plus)
• Excellent written and spoken communication skills
• Proficiency with relevant claims/collections software (Availity, Stedi, or similar)
• Proficiency in Microsoft Office tools or Google Suite Tools
• Experience leveraging AI tools to streamline processes and workflows
• 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 $81,000-$95,000 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.

As an Associate, Payments [RCM] at Maven, you will:

• Review and process complex claims related to Maven's fertility treatments, procedures, applicable medications, and expenses tied to additional paths to parenthood, in accordance with company policy and benefit plan designs
• Review claim to Identify instances of denials, underpayments, overpayments
• Prepare and submit timely, well-documented appeals and reconsiderations to insurance payers for expedited re-processing of claims
• Communicate directly with insurance representatives to follow up on appeals and resolve claim issues
• Identify patterns or trends in denials and escalate systemic issues to management

• Verify member eligibility and benefits ahead of and during claims processing
• Resolve eligibility discrepancies between payer records and member/benefit plan data
• Coordinate prior authorizations where applicable to fertility treatment coverage

• Facilitate timely and accurate payments and resolve payment disputes across payers and claims
• Post and reconcile payments against expected reimbursement; research underpayments and unapplied cash

• Work with both internal and external cross-functional stakeholders to ensure a smooth and efficient payment process
• Maintain and improve SOPs for all Revenue Cycle Management processes

We’re looking for you to bring:

• 2-4 years of experience in revenue cycle management, benefits management, or insurance billing, focused on claims and collections
• Understanding of medical billing, coding, insurance claims processing, and revenue cycle management (fertility claims experience is a plus)
• Excellent written and spoken communication skills
• Proficiency with relevant claims/collections software (Availity, Stedi, or similar)
• Proficiency in Microsoft Office tools or Google Suite Tools
• Experience leveraging AI tools to streamline processes and workflows
• 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 $81,000-$95,000 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.