Member Care Specialist

What you'll be doing: Answering incoming calls from members and providers regarding benefits, eligibility, and claims Researching and resolving complex issues using internal tools, documentation, and outbound outreach Educating members and providers on platform navigation, benefits, and available resources Accurately documenting each interaction and following established procedures De-escalating concerns and handling first-level complaints with professionalism and empathy Supporting appeals processes and ensuring timely follow-up actions are completed

Required Skills and Abilities: Proficiency with Microsoft Office applications, including Outlook, Word, and Excel Strong written and verbal communication skills Excellent attention to detail and solid problem-solving abilities Ability to remain calm, professional, and customer-focused while handling calls

Education and Experience: High school diploma or GED1–2 years of experience in a provider office, healthcare setting, and/or fast-paced call center environment

Preferred Qualifications: At least 1 year of direct experience in healthcare, health insurance, or a related field, with a strong understanding of medical terminology and/or provider office operations Bilingual in Spanish and English preferred This role is located on-site in our downtown Buffalo, NY office. Centivo Values: Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don't give up. Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon. Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive. 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. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.