Payment Operations Associate

Maven is looking for a Payment Operations Associate who will be a critical member of the Payment Delivery team focused on ensuring that members are supported during their fertility journeys, especially when it comes to reducing the financial anxiety associated with fertility treatments. This person will play a critical role in managing claim denial and appeals with payers, and resolving discrepancies for members. This role will be reporting to the Director of Payment Operations. As a Payment Operations Associate at Maven, you will: Review and process complex claims related to Maven’s fertility treatments, procedures and applicable medications, and expenses related to additional paths to parenthood in accordance with company policies and benefits plan designs  Review claims to identify instances of denials and under payments Prepare and submit timely, well-documented appeals and reconsiderations to insurance payers for expedited re-processing of claims Communicate with insurance representatives to follow up on appeals and resolve claim issues Maintain accurate records of appeals, claim statuses, and outcomes Facilitate timely and accurate payments and resolve payment disputes  Identify patterns or trends in denials and escalate systemic issues to management Work with other departments to ensure a smooth and efficient payment process across all stakeholders