Centivo

Data Analyst

• Collaborate with claims and stop loss operations teams to understand analytics and reporting needs that drive efficiency and scalability.
• Scope, gather, and structure requirements into actionable opportunities and solutions.
• Extract, manipulate, and analyze large datasets from claims databases using SQL or similar querying languages.
• Translate data into actionable insights and strategic recommendations that inform process improvements, resourcing decisions, and operational priorities.
• Develop models and algorithms to identify trends, anomalies, root causes of inefficiencies and areas for operational improvement.
• Design and maintain scalable dashboards and reports using tools like Tableau, Power BI, or similar platforms.
• Create and monitor productivity and performance metrics to assess and enhance departmental efficiency.
• Present findings to operations leadership with clear narratives that tie analytics to business outcomes.
• Serve as a technical liaison between claims operations and the core data team to ensure accuracy and quality in analytics.
• Develop and maintain SLA reporting to ensure claims operations meet and exceed client expectations.
• Proactively identify and recommend areas for automation, workflow enhancements, and optimization across the claims lifecycle.
• Ensure data integrity and accuracy across all analyses.

Senior Claims Data Analyst

Operations

• The Client Operations Specialist plays a vital role in supporting our Client Success team with the end-to-end delivery of health insurance services for employer groups, brokers, and individual members
• Act as Subject Matter Expert, representing the voice of the customer and client success, on any product, network, vendor discussions and rollouts
• Identify Client Success needs and requirements related to such rollouts, ensuring timely distribution of deliverables to Client Success
• Ensure accuracy and integrity of client data in internal systems
• Monitor KPIs related to client satisfaction, service level agreements (SLAs), and operational performance
• Alert Client Success if KPI’s are not meeting targets and make recommendations to improve performance

Client Operations Specialist

Customer Success Manager

• Own the client relationship. Serve as the strategic and day-to-day contact for your client portfolio, building deep, consultative partnerships with HR, Finance, and broker/consultant teams.
• Tell a compelling, data-driven story. Translate complex health, claims, and engagement data into meaningful insights that show progress, demonstrate value, and inspire confidence in Centivo’s approach.
• Drive client growth and retention. Lead renewals and strategic planning conversations that highlight measurable outcomes, promote member engagement, and identify opportunities to expand Centivo’s solutions across markets or populations.
• Guide a seamless client journey. Ensure a smooth transition from implementation to ongoing partnership, proactively anticipating client needs and aligning Centivo’s capabilities to meet them.
• Be the client’s voice inside Centivo. Collaborate cross-functionally with operations, analytics, and product teams to ensure we deliver with excellence and continuously enhance the client experience.
• Engage with brokers and consultants. Build trusted relationships that extend Centivo’s reach and strengthen our position as a high-value, innovative partner.
• Champion continuous improvement. Bring forward ideas and feedback that help evolve our client success playbook and enhance how we serve clients every day.

Client Success Executive

Business Analyst

• Triage operational issues, identify root cause and magnitude, recommend solutions
• Lead projects and tasks to completion to improve Claims team efficiency
• Use claims adjudication experience and TPA background to triage vendor and claims issues
• Coordinate with business units and external vendors during client implementations and conversions to determine requirements
• Ensure integration between internal and vendor systems to support client requirements and workflows
• Create process flows for new initiatives and existing processes
• Serve as liaison between business and technical resources
• Identify and articulate business requirements and facilitate brainstorming on solution options
• Assist and participate in claims testing for new technology, vendors, and processes
• Keep abreast of vendor enhancements and integration impacts
• Act as primary liaison with vendor for reported issues and enhancement requests
• Oversee claims platform upgrades and coordinate user acceptance testing
• Identify opportunities to increase automation, resolve system deficiencies, and enhance claims processing and reporting
• Participate in assessment of new technologies, vendors, and system enhancements
• Participate in plan design, strategy, and setup meetings
• Query data and create reporting to analyze issues, trends, and claim performance

Claims Business Analyst

Events

• Accept inbound calls from members and providers on inquiries pertaining to benefits, eligibility, and claims
• Research complex inquiries by use of tools, documentation, and outbound calls
• Educate members and providers on the benefits and navigation of Centivo site, tools, and applications
• Document all interactions and ensure proper processes/procedures are followed and follow-up action is taken
• De-escalate calls when necessary
• Address first-level complaints and provide assistance on appeals as needed;

Member/Provider Care Specialist

Customer Support

• Answer incoming calls from members and providers with questions about benefits, eligibility, and claims
• Research and resolve complex issues using company tools, documentation, and outbound calls
• Educate members and providers on how to navigate the platform, benefits, and resources
• Accurately document every interaction and follow established procedures
• Calmly de-escalate concerns and handle first-level complaints with empathy
• Support appeals processes and ensure timely follow-up actions are taken
• Participate in a team working to deliver affordable, high-quality healthcare solutions

Senior Claims Data Analyst

Client Operations Specialist

Client Success Executive

Claims Business Analyst

Member/Provider Care Specialist

Member Care and Provider Specialist/Customer Service, Healthcare