Member Care and Provider Specialist / Customer Service (Healthcare)

Job Description

Job Description

We exist for workers and their employers who are the backbone of our economy.  That is where Centivo comes in our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Centivo is seeking Member Care / Provider Specialists to join our dynamic team. As a Member Care / Provider Specialist, you’ll be a vital part of that mission, serving as a trusted guide and problem-solver for our members and provider partners. If you're driven by purpose, love helping others, and thrive in a fast-paced environment, we want to hear from you.

Our next paid training program kicks off on December 1, 2025 , so now is the perfect time to apply!

What you'll love about this role :

Supporting members and healthcare providers with inquiries

Solving complex problems with care, empathy, and resourcefulness

Educating members and healthcare providers on benefits and navigation of our site and applications.

Being part of a team that’s disrupting the traditional healthcare model in the best possible way

What you’ll be doing :

Answer incoming calls from members and providers with questions about benefits, eligibility, and claims

Research and resolve complex issues using our tools, documentation, and outbound calls

Educate members and providers on how to navigate our 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

Qualifications :

Required Skills and Abilities :

Familiarity with the Microsoft operating system and its suite of applications (Outlook, Word, Excel)

Ability to communicate professionally, both written and verbal

Solid attention to detail and problem-solving abilities

A calm, professional demeanor when handling calls

Education and Experience :

A high school diploma or GED

1–2 years of experience in a provider office and / or fast-paced call center environment

Preferred Qualifications :

At least 1 year of hands-on experience in healthcare, health insurance, or a related field, with a strong understanding of medical or provider office operations

Bilingual (Spanish / English preferred)

Location :

This role is located 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 .

Who we are :

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. For more information, visit centivo.com.

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.