Payment Operations Associate

Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Recognized for innovation and industry leadership, Maven has been named to the Time 100 Most Influential Companies, CNBC Disruptor 50, Fast Company Most Innovative Companies, and FORTUNE Best Places to Work. Founded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. To learn more about Maven, visit us 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: 

• 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)
• TIME 100 Most Influential Companies (2023)
• Fast Company Most Innovative Companies (2020, 2023)
• Built In Best Places to Work (2023)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)
• Great Place to Work certified (2020, 2021, 2022, 2023, 2024)
• Fast Company Best Workplaces for Innovators (2022)
• Built In LGBTQIA+ Advocacy Award (2022)

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. 

As a Payment Operations Associate at Maven, you will:

• 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.

We’re looking for you to bring:

• 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  

The base salary range for this role is $80,000-$85,00 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.

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.