Job details
Job type full-time
Full job description
Description: centivo is a new type of health plan anchored around leading providers of value-based careCentivo 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 billsWith 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 networksAn 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 populationEmployees 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.
Requirements: summary of role:
The role of the eligibility coordinator is to handle the day-to-day administering of files, data, updates, and transmissions relating to billing and eligibility.
Eligibility coordinators determine the necessary qualifications for enrollment into the group’s medical plansThe job involves fact checking, record keeping and a variety of financial and non-financial tasks.
Responsibilities include:
Knowledge of plan eligibility rules as outlined in the spd for each plan assigned
Reviews system for eligibility, reinstatement, and termination of health care coverage
Compiles weekly check register of claims by client
Releases funds for check runs as directed and completes submission of positive pay to client and/or bank
Monitors and responds to eligibility messages and jqs requests received from concierge
Collaborates with implementation and account management teams on issues related to group and enrollment/funding/cobra
Monitors and assists groups in the mesa provider portal
Manages enrollment and cob
Monitors and processes claims in sds queue
Manages member mailing kit lists for all groups
Confirms all newly eligible members are provided enrollment packets and makes sure that the enrollment process is completed
Requests and evaluates legal documents such as divorce decrees, marriage certificates, birth certificates, etcTo determine dependent eligibility according to plan rules
Reviews monthly status reports and self-payment notices before mailed to members to ensure information is correct
Sends proper enrollment documents to members, including dependents
Qualifications:
Required skills and abilities:
Ability to prioritize and organize own work to meet deadlines
Strong customer service skills
Demonstrated ability to handle multiple assignments competently, accurately, and efficiently
Strong interpersonal skills, establishing rapport and working well with others
Strong knowledge of benefit plans, policies, and procedures, understanding of medical terminology
Education and experience:
High school diploma or ged required, associate’s or bachelor’s degree preferred
Experience working with highly automated and integrated claim adjudication system, el dorado-javelina preferred, but not required
Work location:
An ideal candidate would be assigned to the buffalo, ny office with ability to work from homeFully remote will also be considered for strong candidates.
Job type: full-time
Work location: multiple locations
