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Salary: USD 81,000 - 95,000 / annual
Maven Clinic is seeking a Payment Operations Associate to join its Revenue Cycle Management (RCM) team. This role is central to Maven's mission to make healthcare work for women and families through virtual care delivery.
You will manage complex claims processing related to fertility treatments, procedures, medications, and family-building services. Key responsibilities include reviewing claims to identify denials, underpayments, and overpayments; preparing and submitting appeals and reconsiderations to insurance payers; and communicating directly with insurance representatives to resolve claim issues. You'll verify member eligibility and benefits, coordinate prior authorizations for fertility coverage, and facilitate timely payments while reconciling reimbursements.
You will identify patterns in claim denials and escalate systemic issues to management. Working cross-functionally with internal teams and external payers, you'll maintain and improve standard operating procedures for RCM processes.
The ideal candidate brings 2–4 years of experience in revenue cycle management, benefits management, or insurance billing with a focus on claims and collections. You should understand medical billing, coding, insurance claims processing, and RCM fundamentals. Fertility claims experience is a plus. You'll need proficiency with claims/collections software (Availity, Stedi, or similar), Microsoft Office or Google Suite, and demonstrated ability to leverage AI tools to streamline workflows. Strong written and verbal communication, organizational skills, and the ability to multitask in a fast-paced environment are essential. A bachelor's degree is preferred.
Maven operates a flexible hybrid model. The primary office is in the New York Metropolitan area, with team members required to work onsite three days per week (Tuesday–Thursday). Remote team members in San Francisco, Seattle, Boston, Chicago, and DC attend quarterly in-person collaboration days. Active US work authorization is required.
