Centivo · 3 months ago
Claims Supervisor
Buffalo
Full-time
Hybrid
Mid, Senior Level
$70K/yr - $77K/yr
3+ years expCentivo is an innovative health plan for self-funded employers focused on providing affordable, high-quality healthcare. They are seeking a Claims Supervisor to lead a team of Claims Processors, ensuring accurate claims processing and driving continuous improvement in the department.
Health CareInformation TechnologyMedical
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 (SLA’s)
Educates and mentors claims staff to ensure proper application of client benefit plans to claims processed, at the required quality and production metrics, including establishing performance plans for those falling below expectations with appropriate coaching and mentoring to achieve improvement
Provides reports to department leaders on claim inventory, production, turn-around lag, and quality metrics
Develops policy and procedures to ensure that benefit plans and claim standards are properly administered; assists in developing policies and procedures for operations, and monitors claim staff for compliance
Accountable for positively influencing the morale of the department employees, including setting achievable goals, fostering teamwork by involving team in the design/implementation of solutions to problems
Responsible to establish annual goals for staff that align with organization strategies and personal growth and can provide timely and constructive feedback on performance
Is a liaison for the claims on various projects and/or initiatives including testing needs to support system implementations and/or upgrades
Performs other duties as deemed essential and necessary
Qualification
Required
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 read and understand various forms, documentation, files, and information with the department
Candidate must have at least 3 years of experience with self-funded health care plans, and processing in a TPA environment
Candidate must have at least 3 years of experience supervising a claims team
Candidates must have 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
Past Training Experience
Experience working at TPA
Experience with self-funded plans
Company
Centivo
Centivo offers a digital health plan aimed at self-funded employers looking to provide employees with care.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
$226.4MKey Investors
Morgan HealthB CapitalBain Capital Ventures
2024-09-24Series Unknown· $75M
2024-09-24Debt Financing
2022-07-19Series B· $30M
Leadership Team
Alan Cohen
Chief Product Officer & Co-Founder
Wayne Jenkin
Chief Medical Officer
Recent News
2025-08-26
2025-08-20
Company Ventures
2025-08-12
Company data provided by crunchbase