Claims Business Analyst

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🗽 New York – Remote

🗽 New York – Remote

💵 $80k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

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Centivo

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Centivo is an innovative health plan provider for self-funded employers that focuses on delivering high-quality healthcare at an affordable cost. The company believes in the power of primary care to improve health outcomes and reduce costs. Centivo offers plans with free primary care, no deductibles, and low, predictable copays, thereby encouraging members to utilize their health benefits without financial burden. The plans are curated to meet stringent price and quality standards, promoting a strong relationship with primary care providers and integrating virtual care options. Centivo's approach is designed to reduce overall medical expenses while enhancing the healthcare experience for both employers and employees.

📋 Description

• As a Claims Business Analyst, you will be responsible for triaging operational issues and leading projects and tasks to completion. • You will use your claims adjudication experience and TPA background to triage operational concerns, vendor issues, and related claims issues. • Familiarity with Centivo’s claims systems (Javelina and HealthRules Payer) is preferred. • You will coordinate with all business units and external vendors during client implementations and conversions to determine requirements. • This role ensures seamless integration between internal and vendor systems to support client requirements and operational workflows. • Additionally, you will lead key projects and tasks identified to improve efficiency of Centivo’s Claim team. • This role will use data analytics and other tools to identify areas of improvement needed in the business, scope out the initiative, and then lead the project through to completion.

🎯 Requirements

• Candidates must have at least 5 years of experience within healthcare claims • Candidates must have 3 years of experience working as a Business Analyst • Candidates must have prior experience with highly automated and integrated claim adjudication systems • Understanding of health insurance benefits administration in a self-funded environment • Advanced problem-solving skills, with a track record of researching and resolving operational issues accurately and on time. • Highly organized and able to work independently, using sound judgment to manage priorities and make decisions. • Adapts to changes in the work environment; manages competing demands and deals effectively with frequent changes, delays, or unexpected events, including production schedule pressure. • Builds strong working relationships and influences outcomes across cross-functional teams. • Proficiency in Microsoft Office and other web-based software applications. • Skilled in running queries and analyzing data to identify trends and issues. • Excellent verbal and written communication skills — able to explain complex or technical information clearly, and to understand and interpret complex information from others, including reimbursement policy standards.

🏖️ Benefits

• Offers Equity • Offers Bonus