[Remote] Payment Operations Associate at Maven Clinic

New York, New York, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Digital Health, Women's Health, Family BuildingIndustries

Requirements

Candidates should have 3-6 years of experience in benefits management or insurance focusing on claims adjudication, with a strong preference for fertility or women's health experience. A solid understanding of medical billing, coding, insurance claims processing, and revenue cycle management is necessary. The role requires exceptional attention to detail and accuracy, strong analytical and problem-solving skills, and excellent written and spoken communication abilities. Proficiency in Microsoft Office tools and the ability to work independently and as part of a team, with strong organizational skills and demonstrated ability to multi-task and manage time effectively, are also essential.

Responsibilities

The Payment Operations Associate will evaluate and adjudicate fertility-related healthcare claims in accordance with company policies and benefits plan designs. Responsibilities include researching claims issues, facilitating their resolution by requesting additional information from members, and ensuring all tasks are completed within designated timeframes to meet service-level agreements. The associate must adhere to federal, state, and payer-specific regulations, provide clear explanations of claim determinations and reimbursement policies, and develop/iterate on standard operating procedures for claims adjudication. This role also involves working with other departments to ensure a smooth and efficient reimbursement process.

Skills

Healthcare reimbursement

Claims adjudication

Fertility

Family building

Payment processing

Maven Clinic

Digital health platform for women's healthcare

About Maven Clinic

Maven Clinic provides a digital health platform focused on women's and family health services. It offers a wide range of support, including preconception care, fertility preservation, IVF, adoption, surrogacy, and menopause care. The platform connects users with dedicated Care Advocates and utilizes data-driven insights to ensure equitable access to healthcare, regardless of location or background. This approach helps improve health outcomes and reduces the need for expensive medical procedures. Maven Clinic's services include on-demand appointments with specialized providers, ongoing assessments, and proactive check-ins, which enhance member engagement and allow for early risk identification. The company aims to deliver comprehensive care while achieving significant clinical and business returns on investment.

New York City, New YorkHeadquarters

2014Year Founded

$416.1MTotal Funding

SERIES_FCompany Stage

HealthcareIndustries

1,001-5,000Employees

Benefits

Unlimited paid time off

14 weeks fully paid parental leave and return-to-work plan

Market-based compensation and equity

Medical, dental, and vision plans (100% covered options)

Free membership with One Medical

Free access to Maven, with credits for friends and family

401(k) match

Paid month-long sabbatical after 5 years

Risks

Increased competition from AI-driven startups like Abridge could impact Maven's market position.

Flat deal activity in healthcare IT may slow future funding opportunities for Maven Clinic.

Growing FemTech market could lead to increased competition from new entrants in reproductive health.

Differentiation

Maven Clinic offers comprehensive women's and family health services, including IVF and surrogacy.

The platform provides equitable access to care through dedicated Care Advocates and data insights.

Maven Clinic's holistic approach reduces costly procedures with proactive healthcare interventions.

Upsides

Maven Clinic raised $125M in Series F, becoming the highest valued in its sector.

The rise of FemTech presents opportunities for Maven to expand and capture market share.

Increased employer demand for fertility benefits aligns with Maven's services, boosting its client base.

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