Payment Operations Senior Associate

The role

This person will support program expansion into insurance-based billing by managing claim denials, appeals, and payment issues. They will develop and refine SOPs for claims processing and provide operational reporting.

What you will do

• Develop, document, and iteratively refine SOPs for claims processing
• Review and process complex claims
• 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
• Prepare recurring operational reporting on claims volume, SLA performance, and denial trends
• Identify and escalate systemic issues

Required qualifications

• 4-6 years of experience in benefits management, RCM, or insurance claims
• Experience building or improving operational processes
• Comfort operating with ambiguity and building process from scratch
• Experience partnering cross-functionally with support, finance, or product teams
• Track record of synthesizing operational data into reporting
• 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

Nice to have

• Bachelor’s degree

Benefits

• 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
• Work together days
• 16 weeks 100% paid parental leave
• New parent stipend (for Mavens who've been with us for 1 year+)
• Annual professional development stipend
• Access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting

Before you apply

• Requires active work authorization in the US

About the company

Maven Clinic is the world's largest virtual clinic for women and families. The company partners with employers and health plans to provide end-to-end women's and family health programs.