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Responsibilities:
- Create the blueprint for configuration of the plan from plan documents and/or plan standards.
- Build, validate and test medical and dental plan benefits and associated code mapping logic.
- Make necessary plan building and logic revisions when plans are amended.
Qualifications:
- Knowledge of professional and institutional claims adjudication.
- Ability to interpret plan documents and translate benefits to ICD 10, HCPCS, CPT, CDT and other insurance billing codes.
- Prior experience with a highly automated and integrated claim adjudication systems.
About the Role:
- This position is remote or hybrid, with an ideal candidate assigned to the Buffalo Office.
- You will work with department managers and team leaders to improve efficiency within the company.
- You will maintain the claim system Plan Building mailbox to research and resolve system issues.
Centivo
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. Backed by leading healthcare and technology investors, the company is headquartered in Buffalo, NY and values resilience, uncommon thinking, and positivity.