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Member Care Supervisor – Buffalo

Centivo Corporation

This is a Full-time position in Buffalo, NY posted September 15, 2021.

Centivo is a new type of health plan anchored around leading providers of value-based care.

Centivo saves self-funded employers 15 percent or more compared to traditional insurance carriers and is easy to use for employers and employees.

Centivo’s mission is to bring affordable, high quality healthcare to the millions of working Americans who struggle to pay their healthcare bills.

With Centivo, employers can offer their employees affordable and predictable costs, a high-tech member experience, exceptional service, and a range of benefit options including both proprietary primary care-centered ACO models as well as traditional networks.

An alternative to traditional insurance carriers or third-party administrators (TPAs), Centivo builds proprietary networks and offers all of the technology and service to fully administer health benefits.

Employers get a benefits solution that saves them money, provides full transparency into costs and data, and allows them to offer a range of benefit options to meet the needs of a diverse employee population.

Employees and their families get quality care at affordable and predictable costs, a partner to help them navigate the healthcare system, and a great member experience.

With offices in Buffalo, NY, Denver, CO, New York City and Stamford, CT, Centivo is backed by leading investors including B Capital Group, Bain Capital Ventures, Bessemer Venture Partners, Company Ventures, Define Ventures, F-Prime Capital, HarbourVest Partners, Ingleside Investors, Maverick Ventures, Nassau Street Ventures (an AVG fund), Oxeon Investments, and Rand Capital.

Responsibilities Include: * Supervise the activities of the team and provide direction and guidance on work assignments* Ensure that team performance goals and client SLA’s are being met* Assess individual training needs on an ongoing basis* Instruct and inform new team members* Handle escalations/customer inquiries/complaints received and ensure that appropriate action is taken, including follow up* Stay current on and demonstrate a basic understanding of the business, technologies, content knowledge, processes, procedures and assigned clients* Build effective working relationships with peers, team members, managers, and clients/customers* Operate as back-up and support for other Sup/TL as needed within the appropriate scope of responsibility* Complete daily projects and perform additional duties as requested* Comply with and adhere to all regulatory compliance areas, policies, procedures and “best practices”, including HIPAA, Data Privacy laws and company data security requirements* Answer overflow inbound calls, outbound calls, email, and faxes* Tracking and reporting on volume, metrics, and escalations* Compile data to present to clients Qualifications: Required Skills and Abilities: * Minimum of 1 year of prior supervisor/management experience* Minimum of 1 year of successful customer service experience, in a TPA, in the health, insurance or benefits industry* Knowledge of CPT codes, ICD-9/ICD-10 coding and medical terminology* Ability to provide a high-level member and provider support experience* Demonstrated ability to communicate professionally, both written and verbal* Understanding and awareness of the data privacy regulatory rules in one industry (health, insurance, banking, financial services, credit, and collections) and the willingness to learn and adhere to all legal regulations by handling confidential information with sensitivity and discretion in accordance with HIPAA and Data Privacy laws* Proficiency in Microsoft Office applications and other web-based software applications* Computer knowledge and ability to learn new proprietary computer systems Education and Experience: * High School diploma or GED required* Minimum of 1 year in a supervisory/management role* Minimum 1 year of successful customer service experience in a fast-paced call center required Preferred Qualifications: * Associates degree or Bachelor’s degree* Experience with Medicare billing, Medicare rates, RBR pricing experience or self-funded insurance plan products* Medical office billing/insurance reimbursement experience interacting with insurance companies to resolve coverage* Medical claims processing experience* Bilingual Location: This position may be located in the Buffalo, NY or Denver, CO office, with some work from home flexibility