Senior Member Services Specialist

Maven Clinic
Arizona, District of Columbia, Delaware, Florida, Georgia, Hawaii, Illinois, Kansas, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, Wisconsin
Workplace: RemoteFull timeUSD 82,000 - 96,000 annuallyFunction: Solutions Engineering & Sales EngineeringSkills: ["Investigation","Clear communication","Case management","Customer empathy","Attention to detail"]

Own complex, sensitive member cases end to end—from first contact through resolution—covering appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, and urgent care needs. Handle specialty member calls and everyday support (appointment changes, login issues, enrollment questions). Investigate claim and workflow histories, apply the correct process, communicate clearly on coverage and reimbursement timelines, and drive cases to closure via tools and partner teams.

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Maven Clinic
Maven Clinic
3 days ago

Senior Member Services Specialist

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Source: Company careers pageValidated by: Fursa AI
Last checked: 11 hours agoStatus: Live

Job Summary

Own complex, sensitive member cases end to end—from first contact through resolution—covering appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, and urgent care needs. Handle specialty member calls and everyday support (appointment changes, login issues, enrollment questions). Investigate claim and workflow histories, apply the correct process, communicate clearly on coverage and reimbursement timelines, and drive cases to closure via tools and partner teams.
Location: Arizona, District of Columbia, Delaware, Florida, Georgia, Hawaii, Illinois, Kansas, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, Wisconsin
Workplace: Remote
Employment Type: Full time
Job Function: Solutions Engineering & Sales Engineering
Seniority: Mid level

Key Responsibilities

  • •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 where conversations have already gone badly.
  • •Investigate before replying by pulling history, identifying where the issue broke down, and returning an answer.
  • •Keep members updated on their timeline rather than the company’s, especially when resolution takes days or weeks.
  • •Drive cases through required teams/tools and hand off with enough context so work does not restart.

Pay and Benefits

Salary: USD 82,000 - 96,000 annually
Perks:Health InsuranceDental401kPaid LeaveLearning Budget

Key Requirements

  • •Review member history before responding and provide an answer rather than a status update.
  • •Explain coverage, eligibility, and reimbursement rules clearly and accurately without promising outcomes you don’t control.
  • •Drive complex cases requiring Jira, Compliance, clinics, or benefits administrators through resolution until closed.
  • •Know what can be solved independently versus what must be escalated, and hand off with enough context.
  • •Work assigned shifts including evenings, overnights, weekends, and holidays as applicable.
Experience:HealthcareHealth plansFertility benefits
Skills:InvestigationClear communicationCase managementCustomer empathyAttention to detail
Languages:Spanish
Tech Stack:JiraZendeskSlack

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Maven Clinic
Maven Clinic is a virtual-first women’s and family healthcare platform offering telehealth services, care navigation, and employer-sponsored programs covering fertility, pregnancy, postpartum, pediatrics, and family planning.
Industry: HealthTech
Company Size: Large (251 to 1,000 employees)
Growth: Scaleup
Funding: Series D
Headquarters: New York, United States
Founded: 2014
WebsiteLinkedIn