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Healthcare Enrollment Specialist

2 months ago

Buffalo, New York, United States Centivo Full time
About the Role

Centivo is seeking a highly skilled Healthcare Enrollment Specialist to join our team in Buffalo, NY. As a key member of our team, you will play a critical role in ensuring the smooth administration of healthcare benefits for our clients.

Key Responsibilities
  • Eligibility and Enrollment Management: Review and verify client eligibility, reinstatement, and termination of healthcare coverage, ensuring accuracy and compliance with regulatory requirements.
  • Benefits Administration: Perform weekly audits for assigned clients, using member census data to ensure coverage is accurate and monitor for file feed issues.
  • Problem-Solving and Communication: Identify and resolve enrollment data discrepancies, address client concerns, and provide exceptional customer service.
  • System Management: Manage and validate ID card releases, load, transfer, and archive daily ID card print files, and ensure holds are in place for printing.
  • Collaboration and Coordination: Work with internal teams, external carriers, and vendors to ensure member eligibility is accurately reflected and claims are processed efficiently.
Requirements
  • Education and Experience: High school diploma or GED required; Associate's or Bachelor's degree preferred. 1-2 years of experience in the healthcare industry is preferred but not required.
  • Skills and Abilities: Strong customer service skills, problem-solving and analytical skills, intermediate Microsoft Excel skills, and ability to work within multiple systems/programs.
About Centivo

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. We are anchored around a primary care-based ACO model, saving employers 15 to 30 percent compared to traditional insurance carriers.