Maven is looking for a Claims & Benefits Senior Associate who will be a critical member of the Payment Operations Team focused processing and managing claims and benefits for eligible members. This includes reviewing claims for accuracy, resolving discrepancies, and coordinating with providers to ensure timely payment.

As a Claims & Benefits Senior Associate at Maven, you will

• Process and manage claims for accuracy and timeliness
• Apply guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply appropriate measures to assist in the claim adjudication process.
• Address inquiries, resolve issues and communicate changes to benefits effectively and in a timely fashion
• Review and adjudicate claims; make determinations on whether to pay or deny claims following organizational policies and procedures
• Coordinates responses for phone inquiries and written correspondence related to claim processing issues
• Research and interpret policies and benefits
• Stay up-to-date on changes to healthcare regulations and reimbursement policies
• Process and manage claims for accuracy and timeliness
• Ensure all processes adhere to regulations, compliance standards and company guidelines
• Coordinate with providers to ensure timely payment
• Maintain accurate records and reporting

Qualifications:

• 3+ years of experience in health insurance, ideally in claims processing setting
• Strong understanding of medical billing, coding, insurance claims processing, and revenue cycle management
• Excellent communication skills; this includes written and spoken communication
• Proficient in using relevant software and tools for claims and collection management
• Proficient in Microsoft Office tools
• Ability to work independently and as part of a team
• Strong customer service orientation
• Strong organizational skills; demonstrated ability to multi-task and manage time effectively
• Bachelor’s degree is a plus

For candidates in NYC, CO, or CA, the base salary range for this role is $90,000 - $120,000 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.