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Payment Operations Associate

职能支持全球可投
公司mavenclinic
薪资未公开
工作地点Remote
地域资格全球可投
时区要求无特别要求
用工类型未标注
发布时间13 天前
数据来源Greenhouse
前往企业招聘页投递 →
全球可投:该职位未限制候选人所在地区。仍需注意薪资可能按地区折算,以及实际签约方式(正式雇佣 / 独立合同)。

Maven Clinic 是全球最大的女性和家庭虚拟诊所,致力于让医疗保健为所有人服务。通过 Maven Enterprise,公司与超过 2300 家雇主和医保计划合作,提供贯穿生育和家庭建设、孕产和新生儿护理、育儿和儿科、更年期和中年期的端到端女性和家庭健康项目,改善临床结果,降低医疗成本,并扩大高质量医疗的公平可及性。通过其消费者平台,Maven 提供 30 多个专科的直接虚拟医疗服务,以及专为女性设计的激素和 GLP-1 护理项目。由 CEO Kate Ryder 于 2014 年创立,Maven Clinic 已从包括 General Catalyst、Sequoia、Dragoneer Investment Group、Oak HC/FT、StepStone Group、Icon Ventures 和 Lux Capital 在内的领先医疗和科技投资者处筹集了超过 4.25 亿美元。Maven 被誉为创新和行业领导力的代表,曾入选 TIME 100 最具影响力公司、CNBC 破坏者 50 强、Fast Company 最具创新力公司以及 FORTUNE 最佳工作场所。了解更多请访问 mavenclinic.com

荣获奖项的企业文化,致力于重要使命 – Maven Clinic 获得了超过 30 项工作场所和创新奖项,包括:

  • TIME 100 最具影响力公司(2023、2026)
  • Fortune 改变世界(2024)
  • CNBC 破坏者 50 强榜单(2022、2023、2024)
  • Fortune 最佳职场(千禧一代)(2024)
  • Fortune 最佳医疗职场(2024)
  • Fast Company 最具创新力公司(2020、2023)
  • Fortune 最佳纽约职场(2020、2021、2022、2023、2024)

作为 Associate,Payments [RCM],您将:

  • 根据公司政策和福利计划设计,审查和处理与 Maven 生育治疗、程序、适用药物以及与其他成为父母途径相关的费用有关的复杂索赔
  • 审查索赔以识别拒绝、少付、多付的情况
  • 及时准备并提交有充分记录的上诉和重新考虑申请,以加快索赔的重新处理
  • 直接与保险公司代表沟通,跟进上诉并解决索赔问题
  • 识别拒绝的模式或趋势,并将系统性问题上报给管理层
  • 在索赔处理前和处理期间验证成员资格和福利
  • 解决保险公司与会员资格之间的差异
查看英文原文

Maven Clinic is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Through Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women's and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Through its consumer platform, Maven provides direct access to virtual care across 30+ specialties, as well as dedicated hormone and GLP-1 care programs purpose-built for women. Founded in 2014 by CEO Kate Ryder, Maven Clinic has raised more than $425 million from leading healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. Recognized for innovation and industry leadership, Maven has been named to the TIME100 Most Influential Companies, CNBC Disruptor 50, Fast Company's Most Innovative Companies, and FORTUNE Best Places to Work. Learn more at mavenclinic.com

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, 2026)
  • Fortune Change the World (2024)
  • CNBC Disruptor 50 List (2022, 2023, 2024)
  • Fortune Best Workplaces for Millennials (2024)
  • Fortune Best Workplaces in Health Care (2024)
  • Fast Company Most Innovative Companies (2020, 2023)
  • Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)

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.
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 That Work For You

Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits:

  • Maven for Mavens: 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, and work together days
  • 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
  • Annual professional development stipend and access to a personal career coach through Maven for Mavens
  • 401K matching for US-based employees, with immediate 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 jsmith@mavenclinic.com). 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: security@mavenclinic.com. For general and additional inquiries, please contact us at careers@mavenclinic.com.

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