Payment Operations Senior Associate

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• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)

Maven is looking for a Senior Associate, Payment Operations to support our program expansion into insurance-based billing. This person will play a critical role in managing claim denial and appeals with payers, resolving real time eligibility system errors, and unblocking payment issues. This role will be reporting to the Manager, Revenue Cycle Management.

• →Develop, document, and iteratively refine SOPs for claims processing as new verticals and claim types launch
• →Review and process complex claims, maintaining a high first pass clean claims submission rate 
• →Review claims to identify instances of denials and under payments
• →Serve as the point of resolution for cross-functional needs between RCM, Member Support, and Finance on billing issues
• →Prepare recurring operational reporting on claims volume, SLA performance, and denial trends for program and leadership review
• →Identify and escalate systemic issues, with authority to resolve claims-specific process issues directly, escalating member-experience or product-level issues to the appropriate owner

• 4-6 years of experience in benefits management, RCM, or insurance claims, including experience building or improving operational processes
• Comfort operating with ambiguity and building process from scratch, this role is standing up SOPs for a business line that doesn't have them yet, not following an established playbook
• Experience partnering cross-functionally, ideally with support, finance, or product teams, to resolve process gaps
• Track record of synthesizing operational data into reporting for non-technical or leadership audiences
• Proficient in using relevant software and tools for claims and collection management (Availity, Stedi, etc.)
• 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  
• Bachelor’s degree is a plus

The base salary range for this role is $98,000-$115,000 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.

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.