Member Care and Provider Specialist/Customer Service (Healthcare) at Centivo

Buffalo, New York, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Familiarity with the Microsoft operating system and its suite of applications (Outlook, Word, Excel)
Ability to communicate professionally, both written and verbal
Solid attention to detail and problem-solving abilities
A calm, professional demeanor when handling calls
A high school diploma or GED
1–2 years of experience in a provider office and/or fast-paced call center environment
At least 1 year of hands-on experience in healthcare, health insurance, or a related field, with a strong understanding of medical or provider office operations (preferred)
Bilingual (Spanish/English preferred)

Responsibilities

Answer incoming calls from members and providers with questions about benefits, eligibility, and claims
Research and resolve complex issues using our tools, documentation, and outbound calls
Educate members and providers on how to navigate our platform, benefits, and resources
Accurately document every interaction and follow established procedures
Calmly de-escalate concerns and handle first-level complaints with empathy
Support appeals processes and ensure timely follow-up actions are taken

Skills

Microsoft Outlook

Microsoft Word

Microsoft Excel

Customer Service

Problem Solving

Healthcare Benefits

Claims Processing

Eligibility Verification

Call Handling

De-escalation

Centivo

Affordable health insurance with primary care focus

About Centivo

Centivo provides health insurance focused on making healthcare affordable and accessible. The company emphasizes primary care, offering free primary care services, no deductibles, and low, predictable copays to help keep its members healthier and reduce the need for hospital visits. Centivo generates revenue by charging employers for health plans provided to their employees, which leads to lower medical costs and increased usage of the plans. A key feature of Centivo's offering is its integrated virtual care service, allowing members to access care conveniently. The company is distinguished by its commitment to quality, curating providers based on strict price and quality standards, particularly in primary care. Centivo's goal is to enhance the member experience while lowering overall healthcare costs.

Buffalo, New YorkHeadquarters

2017Year Founded

$183.7MTotal Funding

DEBTCompany Stage

Financial Services, HealthcareIndustries

201-500Employees

Benefits

Insurance: Medical, dental, vision, life & diability

401k plan

Access to a health savings account

Commuting and dependent care FSA

Competitive salary, bonus, & equity

Risks

Integration challenges with Eden Health may disrupt service delivery if not managed well.

Chronic shortages in primary care access could impact Centivo's care delivery model.

Increased competition from AI-driven startups may challenge Centivo's market position.

Differentiation

Centivo emphasizes primary care partnerships to coordinate healthcare needs effectively.

The company offers free primary care, no deductibles, and low, predictable copays.

Centivo integrates virtual care and mental health services for comprehensive healthcare solutions.

Upsides

Centivo raised $75M to expand affordable health plans amid rising U.S. healthcare costs.

Acquisition of Eden Health enhances Centivo's virtual care and mental health services.

Growing trend of virtual care aligns with Centivo's integrated virtual care service.

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