Member Care Specialist

Centivo; Buffalo (NY); On-site; USD 36,000 - 48,000; Full time

Job summary

Centivo is seeking a Customer/Member Care Specialist to join our Buffalo, NY team on-site. In this role, you will assist members and providers with benefits, eligibility, and claims, using empathy and clear communication to resolve issues.

You will document interactions, guide users through our platform, and support escalation and appeals processes, helping to improve the healthcare experience for our members and provider partners daily.

Qualifications

• Proficiency with Microsoft Office (Outlook, Word, Excel).
• Strong written and verbal communication skills.
• Excellent attention to detail and problem-solving.
• Ability to stay calm, professional, and customer-focused on calls.
• High school diploma or GED.
• 1–2 years in a provider office, healthcare setting, or fast-paced call center.

Responsibilities

• Answer incoming calls from members and providers about benefits, eligibility, and claims.
• Research and resolve complex issues using internal tools and documentation.
• Educate members and providers on platform navigation, benefits, and resources.
• Document interactions accurately and follow procedures.
• De-escalate concerns and handle first-level complaints with empathy.
• Support appeals processes and ensure timely follow-up actions.

Skills

Microsoft Office

Written communication

Verbal communication

Attention to detail

Customer service

Education

High school diploma or GED

Tools

Outlook

Word

Excel

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 Specialists to join our dynamic team. This is an in-person, on-site role based in our downtown Buffalo, NY office. In this role, you will play an important part in our mission by serving as a trusted resource and problem-solver for both members and provider partners. If you are purpose-driven, enjoy helping others, and thrive in a fast-paced environment, we would love to hear from you.

Our next paid training program begins Monday, October 12, 2026, making this a great time to apply.

What you'll love about this role:

• Supporting members and healthcare providers with questions and service needs
• Solving complex issues with empathy, resourcefulness, and care
• Educating members and providers on benefits, tools, and navigation of our site and applications
• Being part of a team that is improving the healthcare experience in a meaningful way

What you’ll be doing:

• Answer incoming calls from members and providers regarding benefits, eligibility, and claims
• Research and resolve complex issues using internal tools, documentation, and outbound outreach
• Educate members and providers on platform navigation, benefits, and available resources
• Accurately document each interaction and follow established procedures
• De‑escalate concerns and handle first‑level complaints with professionalism and empathy
• Support appeals processes and ensure timely follow‑up actions are completed

Qualifications:

Required Skills and Abilities:

• Proficiency with Microsoft Office applications, including Outlook, Word, and Excel
• Strong written and verbal communication skills
• Excellent attention to detail and solid problem‑solving abilities
• Ability to remain calm, professional, and customer‑focused while handling calls

Education and Experience:

• High school diploma or GED
• 1-2 years of experience in a provider office, healthcare setting, and/or fast‑paced call center environment

Preferred Qualifications:

• At least 1 year of direct experience in healthcare, health insurance, or a related field, with a strong understanding of medical terminology and/or provider office operations
• Bilingual in Spanish and English preferred

Location:

This role is located on-site 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.