Claims Compliance Manager
CentivoBuffalo, New York, United States • New York, New York, United States
Posted March 17, 2026
Full Time
About the Company
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.
Job Description
The Claims Compliance Manager – Health Care Claims serves as the organization's subject matter expert on regulatory compliance matters pertaining to self-funded and level-funded health plan products.
Requirements
- 5 years of experience in health care compliance
- Specific exposure to self-funded and/or level-funded group health plans in a TPA environment
- Demonstrated, hands-on expertise with CMS Section 111 reporting, RxDC D2/P2 reporting, Gag Clause Attestation, TiC/MRF compliance, PCORI filings, and NSA/IDR processes
Benefits
- Flexible Work Schedule
- Professional Development Opportunities
- Commuter Benefits
