Payment Operations Associate, Maven Clinic
Claims Adjudicator
$80-85k
You will also be entitled to receive stock options
Virtual clinic for women's and family health
Open for applications
Virtual clinic for women's and family health
501-1000 employees
Open for applications
$80-85k
You will also be entitled to receive stock options
501-1000 employees
Company mission
To make healthcare work for all of us.
Role
Who you are
- 3-6 years of experience in benefits management or insurance focusing on claims adjudication; fertility or women’s health experience strongly preferred
- Understand medical billing, coding, insurance claims processing, and revenue cycle management
- Exceptional attention to detail and accuracy
- Strong analytical and problem-solving skills
- Excellent communication skills; this includes written and spoken communication
- 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
What the job involves
- Maven is looking for a Payment Operations Associate who will adjudicate claims using their specialized experience in healthcare reimbursement, particularly within fertility and/or family building
- This role is responsible for reviewing, processing, and adjudicating healthcare claims related to fertility treatments in accordance with Enterprise benefit plans, and regulatory requirements
- The role ensures accuracy, compliance, and timely resolution of claims
- This position will report to the Director of Payment Operations
- Evaluate and adjudicate fertility-related healthcare claims (e.g., IVF, egg retrieval, preservation, donor services, adoption services, surrogacy-related treatments) in accordance with company policies and benefits plan designs
- Researches claims issues and facilitates the resolution of claims issues, including requesting additional information and documentation from Members
- Ensure that all tasks are completed within designated timeframes to meet internal and external service-level agreements (SLAs)
- Adhere to federal, state, and payer-specific regulations (e.g., HIPAA, ERISA)
- Provide clear explanations of claim determinations and reimbursement policies
- Develop and iterate on standard operating procedures related to claims adjudication processes
- Work with other departments to ensure a smooth and efficient reimbursement process
Our take
Maven is a virtual care provider that is particularly focused on delivering better outcomes for women. Its online pregnancy, fertility, and pregnancy clinic gives users holistic care. The digital health model delivered by Maven is intended to make healthcare services more accessible: it aims to support those that have been marginalized by the traditional health care system.
This means that Maven forms part of the global digital health market; a burgeoning sector of the Internet economy. Many companies are already delivering digital healthcare solutions: rivals to Maven include Doctor On Demand, Heal, Pager, 98point6 , K Health, Lemonaid, MDLIVE, First Stop Health and HealthTap. However, Maven's focused on marginalised groups is what sets it apart.
Maven has received significant funding as it continues to address areas of underrepresented healthcare coverage, such as treatment of postnatal depression. As the company grows, Maven will use this new funding to continue to personalise its platform and enhance its service's cultural flexibility, increasing its support networks across all stages of family and reproductive life. Recent examples of expansion is new product offering for personalised support for those trying to conceive naturally.
Kirsty
Company Specialist at Welcome to the Jungle
Insights
Company
Funding (last 2 of 10 rounds)
Oct 2024
$125m
SERIES F
Nov 2022
$90m
SERIES E
Total funding: $427.8m
Company 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)
- Annual professional development stipend and access to a personal career coach through Maven
- 401K matching for US-based employees (immediately vesting)
Company HQ
Hudson Square, New York, NY
Leadership
Kate Ryder
(CEO)Prior to founding Maven in 2014, Kate worked in venture capital and as a journalist, writing for the Economist from Southeast Asia, New York and London and for the New Yorker.
Salary benchmarks
We don't have enough data yet to provide salary benchmarks for this role.
Submit your salary to help other candidates with crowdsourced salary estimates.
Share this job
View 19 more jobs at Maven Clinic