Senior Member Services Specialist

🕒 il y a 13 jours

🌵 Arizona, District of Columbia, +24 états de plus – Distant

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💵 $82 000 - $96 000 / an

⏰ Temps Plein

🟠 Senior

🦅 Parrain de Visa H1B

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👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Maven Clinic

Maven Clinic

201 - 500 employés

Fondée en 2014

🏥 Santé

⚕️ Assurance santé

📡 Télécommunications

Healthcare • Healthcare Insurance • Telecommunications

Maven Clinic est un fournisseur de télésanté pionnier dédié à la santé des femmes et des familles. L'entreprise offre un soutien complet à travers les différentes étapes de la vie, telles que la fertilité, la maternité, la parentalité et la ménopause. Maven Clinic combine l'expertise clinique avec un modèle de soins virtuels intuitif pour améliorer les résultats de santé et réduire les coûts pour les familles du monde entier. Avec un accent sur les soins personnalisés, elle connecte les membres à des spécialistes à la demande pour répondre à leurs besoins cliniques, émotionnels et financiers de manière transparente.

Description

• Own complex and sensitive member cases end to end, including appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, and urgent care needs • Take member calls on specialty workflows, including difficult conversations • Identify the appropriate workflow for denials, appeals, denied applications, and denied claims • Investigate case history, identify breakdowns, and provide definitive answers • Keep members updated according to their timelines • Explain coverage, eligibility, and reimbursement rules clearly and accurately • Drive cases involving Jira, Compliance, clinics, or benefits administrators through resolution • Escalate and hand off cases with sufficient context • Handle general support volume across programs and channels • Identify recurring member issues and propose practical solutions • Work assigned shifts, including evenings, overnights, weekends, and holidays, as applicable

🎯 Exigences

• Active work authorization in the US • Experience with claims, appeals, reimbursement, or payments (nice to have) • Experience with fertility benefits, specialty healthcare, or financial operations (nice to have) • Experience with Zendesk, Jira, and Slack (nice to have) • Experience mentoring peers or supporting QA programs (nice to have) • Spanish fluency, written and verbal (nice to have) • Ability to work assigned shifts, including evenings, overnights, weekends, and holidays, as applicable • Role open to candidates in AZ, DC, DE, FL, GA, HI, IL, KS, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OR, PA, SC, TN, TX, VA, VT, WI

🏖️ Avantages

• Equity • Employer-covered health, dental, and insurance plan options • Access to Maven’s full platform and specialists, including mental health, reproductive health, family planning, and pediatrics • Wellness partnerships • Hybrid work, in-office meals, and work-together days • 16 weeks of 100% paid parental leave • New parent stipend for employees with 1+ year of service • Annual professional development stipend • Personal career coach through Maven for Mavens • 401(k) matching for US-based employees, with immediate vesting

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