Senior Member Services Specialist
Maven ClinicTelemedicine company
Remote$82,000 - $96,000Senior
StepStone Group
General Catalyst
Sequoia
Oak HC/FT
Dragoneer Investment Group
Icon Ventures
Operations & StrategyNew
About the role
TL;DR
Manage complex member cases, resolve issues, and provide support for women's and family health programs.
- •Maven Clinic is seeking a Senior Member Services Specialist to manage complex and sensitive member cases.
- •This role involves resolving issues related to reimbursements, payments, and coverage changes, requiring a high level of trust and attention to detail.
- •Key Responsibilities Own complex and sensitive cases end to end, including appeals, denied claims, and coverage loss.
- •Investigate issues thoroughly before responding and keep members updated on case timelines.
- •Explain coverage, eligibility, and reimbursement rules clearly and accurately.
- •Collaborate with internal teams and external partners to drive case resolution.
- •Handle general support volume alongside complex escalations.
- •Requirements Experience investigating and resolving complex member issues.
- •Ability to explain complex insurance and healthcare rules in simple terms.
- •Strong communication and problem-solving skills.
- •Experience working with tools like Jira and Zendesk is a plus.
- •Ability to work assigned shifts, including evenings, overnights, weekends, and holidays.
Required skills
JiraSlackCompliance Management
Domain expertise
healthcare
Benefits & perks
equity, health insurance, dental insurance, parental leave, professional development stipend, 401K matching
Tech stack
JiraCompliance ManagementSlack
