Centivo

The Claims QA Auditor is primarily responsible for pre-payment, post-payment, and adjudication audits of claims across multiple employer groups and products, including complex high-dollar claims. Responsibilities include performing auditing of claims, ensuring processing, payment, and financial accuracy, completing reporting of audits finalized with decision methodology, communicating corrections and adjustments to Examiners, identifying and escalating trends, and more.

The Recovery Analyst is primarily responsible for managing all file requirements from beginning to end for subrogation cases, No Surprises Act (NSA) disputes, and overpayment recoveries with the assigned third-party vendor. This includes researching paid claims, answering inquiries, coordinating with other departments, and adjusting claims based on overpayments of claims and settlements. This role requires acting as an interface between internal and external customers and maintaining good relationships.