Teams at Centivo

Leads Centivo’s Claims Management Ancillary Services and Plan Documents functions, overseeing strategy, compliance, quality, performance, workforce planning, and process improvement. Ensures accurate and timely SPDs, SMMs, SBCs, amendments, claims audits, appeals, recoveries, subrogation, and No Surprises Act processes. Manages two functional leaders, develops team performance, monitors operational KPIs, partners cross-functionally, and serves as the operational authority for clients, brokers, TPAs, and stop-loss carriers.

Lead and coach a claims processing team for self-funded employer health plans, enforce SLAs and quality standards, manage claim inventory and backlog, develop policies and procedures, collaborate with Quality/Training and System teams, oversee appeals/subrogation/overpayments, and report performance metrics.

Manages employer-sponsored health plan document preparation, review, updates, and submission. Oversees team workloads, client onboarding, plan changes, compliance with ERISA and related regulations, and communication with clients, brokers, vendors, and internal teams. Leads process improvements, trains new hires, verifies eligibility and plan requirements, identifies missing information, and escalates issues. Maintains current knowledge of healthcare benefits regulations and ensures accurate SBC, SPD, SMM, and plan amendment documentation.