Remote Jobs at Centivo

Candidates should have relevant experience in the healthcare industry or a related field. A strong understanding of health insurance models and a commitment to improving healthcare accessibility are preferred.

Candidates should possess a Bachelor's degree in Business Administration, Human Resources, or a related field, and have at least three years of experience in workforce management, scheduling, or a similar analytical role. Strong analytical and problem-solving skills are required, along with proficiency in data analysis and reporting tools. Familiarity with call center operations and key performance indicators (KPIs) is also beneficial.

Candidates should possess a High School diploma or equivalent, with an Associate degree being preferred. A minimum of one year of experience in health plan operations, claims processing, subrogation, or a related field is required. Proven organizational, reasoning, problem-solving skills, and attention to detail are essential. Strong verbal and written communication skills are necessary, along with knowledge of applicable rules, insurance principles, and subrogation/NSA concepts. The ability to …

Candidates should possess knowledge of professional and institutional claims adjudication and the ability to interpret plan documents and amendments. They must be able to translate benefits into ICD 10, HCPCS, CPT, and CDT codes, demonstrate exemplary customer service skills, and adapt to a constantly changing environment. Strong organizational skills, problem-solving abilities, and the capacity to work independently in a fast-paced, agile setting are essential. Proficiency in Microsoft Office a…

Candidates must possess demonstrated ability to identify platform limitations requiring external vendor collaboration, perform contract reviews for configuration accuracy, and analyze claims for pricing accuracy against contract requirements. Exemplary customer service skills, excellent analytical and problem-solving skills, and the ability to work independently and as part of a team are essential. The role requires multitasking, critical thinking, strong attention to detail and accuracy, and th…

Candidates must possess strong organizational and multi-tasking skills with excellent attention to detail. Required skills include strong written, verbal, and interpersonal communication abilities, with a particular aptitude for identifying and clearly articulating inconsistencies and issues. Familiarity with ERISA, Internal Revenue Code, HIPAA, MSP, COBRA, ACA, and WHCRA is essential. A Bachelor's degree is preferred.

- Thorough understanding of insurance policies, claims handling processes, and legal requirements associated with claims - Strong leadership and team management skills, with the ability to effectively manage and motivate a team - Ability to analyze claims data and make informed decisions based on findings - Previous experience in claims processing or a related field, including supervisory experience - Understands health insurance benefit administration in a Self-Funded environment - Ability to r…

- Bachelor's degree or equivalent experience - 10 years’ experience as Client Success Executive (Account Management) in employer-sponsored health plans - 5 years’ experience working with self-funded accounts - 5 years’ experience working at a TPA or direct carrier - Demonstrated technical expertise in working with self-funded employers, including building compelling, data-driven financial narratives; analyzing stop-loss performance and renewal dynamics; and translating complex plan and network p…

- Experience working with health insurance products (HMO, PPO, HDHP, etc.), funding types (fully insured, ASO, Level Funded), and regulations (ACA, HIPAA) - Strong organizational and project management skills - Proficiency with MS Office (Excel, Outlook, Word) - Excellent written and verbal communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex informat…

- Bachelor’s degree in Data Science, Statistics, Healthcare Administration, or a related field - 5 years of experience in data analytics, preferably within healthcare or insurance claims operations - 5 years of experience in healthcare, claims processing, stop loss reporting and data needs and relevant regulations (e.g., ACA, HIPAA) - Proficiency in SQL with the ability to write complex queries and manipulate large datasets - Strong skills in Python or R for data analysis and insight generation …