Senior Member Services Specialist

🔥 0 minutes ago

🌵 Arizona, District of Columbia, +24 more states – Remote

🌵 Arizona – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🌽 Illinois – Remote 🌪️ Kansas – Remote 🦞 Maine – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $82k - $96k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Maven Clinic

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

📡 Telecommunications

Healthcare • Healthcare Insurance • Telecommunications

Maven Clinic is a pioneering telehealth provider dedicated to women's and family health. The company offers comprehensive support through various life stages, such as fertility, maternity, parenting, and menopause. Maven Clinic combines clinical expertise with an intuitive virtual care model to deliver improved health outcomes and lower costs for families around the world. With a focus on personalized care, it connects members to on-demand specialists to address their clinical, emotional, and financial needs seamlessly.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

• 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