Senior Associate, Claims & Benefits

Maven is the largest virtual clinic for women's and family health, offering continuous, holistic care for fertility and family building through maternity, parenting, pediatrics and menopause. Maven's award-winning digital programs are trusted by leading employers and health plans to reduce costs and drive better maternal health outcomes, as well as enhance DE&I in benefits programs. Founded in 2014 by CEO Kate Ryder, Maven has been recognized as Fast Company's #1 Most Innovative Health Company and has grown to 15 million lives covered. Maven has raised $300 million in funding from leading investors including General Catalyst, Sequoia, Oak HC/FT, Dragoneer Investment Group and Lux Capital.
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)
• CNBC Disruptor 50 List (2022, 2023)
• Fast Company Most Innovative Companies (2020, 2023)
• Built In Best Places to Work (2023)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023)
• Great Place to Work certified (2020, 2021, 2022, 2023)
• Fast Company Best Workplaces for Innovators (2022)
• Built In LGBTQIA+ Advocacy Award (2022)

Maven is looking for a Claims & Benefits Senior Associate who will be a critical member of the Payment Operations Team focused processing and managing claims and benefits for eligible members. This includes reviewing claims for accuracy, resolving discrepancies, and coordinating with providers to ensure timely payment.
As aClaims & Benefits Senior Associate at Maven, you will

• Process and manage claims for accuracy and timeliness
• Apply guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply appropriate measures to assist in the claim adjudication process.
• Address inquiries, resolve issues and communicate changes to benefits effectively and in a timely fashion
• Review and adjudicate claims; make determinations on whether to pay or deny claims following organizational policies and procedures
• Coordinates responses for phone inquiries and written correspondence related to claim processing issues
• Research and interpret policies and benefits
• Stay up-to-date on changes to healthcare regulations and reimbursement policies
• Process and manage claims for accuracy and timeliness
• Ensure all processes adhere to regulations, compliance standards and company guidelines
• Coordinate with providers to ensure timely payment
• Maintain accurate records and reporting

Qualifications: 

• 3+ years of experience in health insurance, ideally in claims processing setting
• Strong understanding of medical billing, coding, insurance claims processing, and revenue cycle management
• Excellent communication skills; this includes written and spoken communication
• Proficient in using relevant software and tools for claims and collection management
• Proficient in Microsoft Office tools
• Ability to work independently and as part of a team
• Strong customer service orientation
• Strong organizational skills; demonstrated ability to multi-task and manage time effectively
• Bachelor's degree is a plus

For candidates in NYC, CO, or CA, the base salary range for this role is $90,000 - $120,000 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.
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 & Perks:
We are reimagining what a supportive workplace looks like, from the inside out. On top of standards such as employer-covered health, dental, and insurance plan options, and generous PTO, we offer an all-of-you, inclusive approach to benefits:

• Maven for Mavens: access to the full platform and specialists, including care for everything from mental health, reproductive health, family planning, pediatrics.
• Whole-self care through wellness partnerships
• Weekly breakfast, lunch, and get-togethers
• 16 weeks 100% paid parental leave, flexible time upon return, and $1.5K/mo for 2 months, new parent stipend (for Mavens who've been with us at least six months)
• Udemy, annual professional development stipend, and access to a personal career coach through Maven
• 401K matching for US-based employees (immediately 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 [email protected]). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: [email protected] . For general and additional inquiries, please contact us at [email protected] .