Centivo
Join to apply for the
Claims Supervisor
role at
Centivo .
This role compensates between
$70,000
and
$80,000
per year, depending on skills and experience.
Base pay range $70,000.00/yr - $80,000.00/yr
We exist for workers and their employers—the backbone of our economy. Centivo’s mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their bills. By providing a primary‑care‑based ACO model, we help employers save 15–30% compared to traditional carriers.
Responsibilities
Demonstrates knowledge and understanding of benefit administration for self‑funded healthcare plans
Ensures that claims are processed and paid in accordance with benefit plans, pricing agreements, and required authorizations
Manages the inventory of claims against standard service level agreements (SLAs)
Educates and mentors claims staff to ensure proper application of client benefit plans and to meet quality and productivity metrics, coaching underperforming staff
Provides reports to department leaders on claim inventory, production, turnaround lag, and quality metrics
Develops policy and procedures to ensure proper administration of benefit plans and claims standards; monitors staff for compliance
Influences team morale by setting achievable goals and fostering teamwork through collaborative solution design
Establishes annual goals that align with organizational strategy and offers timely, constructive feedback on performance
Acts as a liaison for claims on projects, including testing needs to support system implementations and upgrades
Performs other duties as deemed essential and necessary
Qualifications Required Skills and Abilities
Thorough understanding of insurance policies, claims handling processes, and legal requirements
Strong leadership and team management skills, capable of motivating and developing staff
Analytical skills to evaluate claims data and make informed decisions
Previous experience in claims processing or a related field, with supervisory experience
Knowledge of health insurance benefit administration in a self‑funded environment
Ability to read and interpret diverse documentation and files within the department
Education and Experience
At least 3 years of experience with self‑funded health care plans and processing in a TPA environment
At least 3 years of experience supervising a claims team
Prior experience with a highly automated and integrated claim adjudication system
Experience working with HealthRules Payer
Understanding of health insurance benefits administration in a self‑funded environment
Preferred Qualifications
Past training experience
Experience working at a TPA
Experience with self‑funded plans
Work Location
An ideal candidate would be assigned to the Buffalo office with the ability to work from home
If not in the Buffalo area, the opportunity can be remote
Leadership Skills & Behaviors
Strategic thinking—identify patterns and craft future direction
Business acumen—understand risks and opportunities across functions
Systems/analytical thinking—integrate information and anticipate relationships
Flexibility—navigate ambiguity and deliver actionable next steps
Communication—share vision, strategy, and critical information with clarity
Clarification—define expectations and ensure understanding
Coaching—provide recognition, feedback, and support growth
Connection—help team see common purpose and broader impact
Customization—tailor support to each team member’s unique strengths
Who we are Centivo is an innovative health plan for self‑funded employers, aimed at delivering affordable, high‑quality healthcare. Our ACO‑based model saves employers 15–30% compared to traditional carriers. Employees benefit from free primary care, virtual services, predictable copays, and a no‑deductible benefit design. Centivo serves employers ranging from 51 employees to Fortune 500 companies. Headquarters: Buffalo, NY; additional offices: New York City and Buffalo.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Finance and Sales
Industries Insurance
Referrals increase your chances of interviewing at Centivo by 2x.
#J-18808-Ljbffr
Claims Supervisor
role at
Centivo .
This role compensates between
$70,000
and
$80,000
per year, depending on skills and experience.
Base pay range $70,000.00/yr - $80,000.00/yr
We exist for workers and their employers—the backbone of our economy. Centivo’s mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their bills. By providing a primary‑care‑based ACO model, we help employers save 15–30% compared to traditional carriers.
Responsibilities
Demonstrates knowledge and understanding of benefit administration for self‑funded healthcare plans
Ensures that claims are processed and paid in accordance with benefit plans, pricing agreements, and required authorizations
Manages the inventory of claims against standard service level agreements (SLAs)
Educates and mentors claims staff to ensure proper application of client benefit plans and to meet quality and productivity metrics, coaching underperforming staff
Provides reports to department leaders on claim inventory, production, turnaround lag, and quality metrics
Develops policy and procedures to ensure proper administration of benefit plans and claims standards; monitors staff for compliance
Influences team morale by setting achievable goals and fostering teamwork through collaborative solution design
Establishes annual goals that align with organizational strategy and offers timely, constructive feedback on performance
Acts as a liaison for claims on projects, including testing needs to support system implementations and upgrades
Performs other duties as deemed essential and necessary
Qualifications Required Skills and Abilities
Thorough understanding of insurance policies, claims handling processes, and legal requirements
Strong leadership and team management skills, capable of motivating and developing staff
Analytical skills to evaluate claims data and make informed decisions
Previous experience in claims processing or a related field, with supervisory experience
Knowledge of health insurance benefit administration in a self‑funded environment
Ability to read and interpret diverse documentation and files within the department
Education and Experience
At least 3 years of experience with self‑funded health care plans and processing in a TPA environment
At least 3 years of experience supervising a claims team
Prior experience with a highly automated and integrated claim adjudication system
Experience working with HealthRules Payer
Understanding of health insurance benefits administration in a self‑funded environment
Preferred Qualifications
Past training experience
Experience working at a TPA
Experience with self‑funded plans
Work Location
An ideal candidate would be assigned to the Buffalo office with the ability to work from home
If not in the Buffalo area, the opportunity can be remote
Leadership Skills & Behaviors
Strategic thinking—identify patterns and craft future direction
Business acumen—understand risks and opportunities across functions
Systems/analytical thinking—integrate information and anticipate relationships
Flexibility—navigate ambiguity and deliver actionable next steps
Communication—share vision, strategy, and critical information with clarity
Clarification—define expectations and ensure understanding
Coaching—provide recognition, feedback, and support growth
Connection—help team see common purpose and broader impact
Customization—tailor support to each team member’s unique strengths
Who we are Centivo is an innovative health plan for self‑funded employers, aimed at delivering affordable, high‑quality healthcare. Our ACO‑based model saves employers 15–30% compared to traditional carriers. Employees benefit from free primary care, virtual services, predictable copays, and a no‑deductible benefit design. Centivo serves employers ranging from 51 employees to Fortune 500 companies. Headquarters: Buffalo, NY; additional offices: New York City and Buffalo.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Finance and Sales
Industries Insurance
Referrals increase your chances of interviewing at Centivo by 2x.
#J-18808-Ljbffr