Centivo

Analyst

• Prepare documentation, review claim history, and other documentation related to overpayment, subrogation, and NSA requests.
• Utilize available resources to investigate claim situations for overpayment, subrogation, and NSA cases.
• Follow-up with responsible departments and delegated entities to ensure compliance.
• Monitors daily and weekly inventory to ensure internal and regulatory timeframes are met.
• Identify areas of potential improvement and provide feedback and recommendations to management on issue resolution, quality improvement, network contracting, policies and procedures, administrative costs, cost-saving opportunities, best practices, and performance issues.
• Notifies the assigned vendors and clients of the subrogation and recovery interest; confers with other parties, internal departments, and clients concerning potential settlement or other actions.
• Represents Centivo in meetings concerning recovery, subrogation, and NSA matters, including facilitating calls between Centivo’s third-party vendor and the client, to obtain final approval.
• Maintain data entry requirements for all complaints and appeals.
• Perform any other additional tasks or duties as assigned or required.

Recovery Analyst

QA Engineer

• Oversight and management of the Claims Quality Assurance Team, including mentoring the team, implementing and coaching through performance improvement plans, and training auditors on job performance expectations.
• Reviewing audits of claims, ensuring processing accuracy by verifying all aspects of the audit have been handled correctly and according to both standard processes and the Client’s summary plan description.
• Managing the inventory of audits against standard service level agreements (SLA’s) and reporting requirements.
• Compiling reporting of audits completed, with decision methodology for procedural and monetary errors which are used for quality reporting and trending analysis utilizing quality tools.
• Identifying trends based on the quality reviews, identifies quality improvement opportunities and partners with training team to develop programs.
• Partnering with Claims Department Leadership and Training Lead on any problematic issues warranting immediate corrective action.

Claims QA Auditor – Lead

Product Manager

• Oversee the complete product lifecycle from conception to launch and beyond
• Track product and market analytics to inform significant decisions and define key performance indicators (KPIs) to measure product success
• Prioritize features, manage trade-offs, and ensure products meet both market demands and customer expectations
• Work with and through other leaders and cross-functional teams, to ensure alignment across business stakeholders, product, engineering, marketing and development teams
• Communicate development progress, suggestions, and concerns internally; provide solutions if roadblock arise
• Allocate budgets effectively across product initiatives and develop strategies to increase revenue and profitability through product initiatives
• Analyze market trends, opportunities, and the competitive landscape to identify emerging opportunities and position the company’s products as competitive and differentiated in the marketplace
• Serve as the face and voice of the product, building Centivo’s reputation as a market leader, through speaking engagements, press, thought leadership and representation the company externally at industry conferences
• Builds and leads high performing teams through setting direction, managing performance and developing talent within and mentoring others outside the function

Recovery Analyst

Claims QA Auditor – Lead

VP Product Management