Maven Clinic

Senior Billing Specialist

Maven Clinic

full-time

Posted on:

Origin:  • 🇺🇸 United States • California, Colorado, New York

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Salary

💰 $100,000 - $120,000 per year

Job Level

Senior

Tech Stack

Maven

About the role

  • Lead the resolution of complex financial and benefits billing escalations, serving as a key expert to ensure accurate member financial tracking and provide equitable solutions for members, employers, and insurers.
  • Investigate and resolve escalated cases involving billing errors, incorrect benefit calculations, eligibility disputes, overpayments, insurance review and balance mismatches.
  • Perform root-cause analysis on multi system issues (e.b, billing delays, data reconciliation, error tracking) and coordinate corrective actions—such as claim adjustments, accumulator adjustments, or balance reconciliations—with internal and external partners.
  • Act as the primary bridge between Operations, Product and Engineering, Support, Customer Success, Finance, Employers, and Payers to clarify issues and expedite resolutions.
  • Reconcile claims data, denial reports, and finance outputs across many platforms to ensure accurate benefit balances and member statements.
  • Track cases through resolution; maintain meticulous issue documentation across multiple systems.
  • Proactively identify trends in escalations; propose and implement systematic process improvements to reduce recurrence.
  • Communicate clearly and compassionately with members and stakeholders about resolution steps, outcomes, and next actions.

Requirements

  • Bachelor’s degree in Healthcare Administration, Finance, Business, or related field; or equivalent experience preferred
  • 3+ years of relevant experience in medical billing, health benefits, or escalation management
  • Proven ability to handle complex billing escalations (e.g., accumulator discrepancies, eligibility, overpayments, billing corrections).
  • Deep understanding of claims lifecycle, benefits design, accumulations logic, AR workflows, and insurance adjudication.
  • Familiarity with billing systems (EHRs, clearinghouses), issue tracking tools (Zendesk, Jira, etc.), and data/reporting platforms (Google Sheets, Looker).
  • Highly detail‑oriented and structured, with strong organizational skills
  • Excellent critical‑thinking skills for root‑cause analysis and effective resolution of multi‑stakeholder issues.
  • Outstanding verbal and written communication, adept at translating billing data into clear, confident, and definitive recovery plans for all stakeholders.
  • Strong cross‑functional collaboration with member services, care, finance, employers, providers, and insurers.Empathy-driven and member‑centric in handling escalated cases
  • Comfortable adapting to shifting priorities in a fast-paced environment.
  • Creative problem-solver with resourcefulness to drive innovative escalations strategies.