Escalation Response Specialist II

Centene Corp.; Northern (KY); Hybrid; USD 42,000 - 56,000; Full time

Job summary

Centene Corp. is seeking an Escalation Response Specialist II to handle escalated inquiries and complaints across multiple channels. This role supports timely resolutions, tracks outcomes, and collaborates with departments to improve processes and customer experience.

The position requires a High School diploma or GED with 1–2 years of related experience, and availability for peak-month weekend shifts on a rotational schedule. Remote work options are available.

Qualifications

• Requires a High School diploma or GED. 1–2 years of related experience.

Responsibilities

• Provides timely and appropriate resolutions to escalated issues from various channels.
• Liaises between departments to ensure timely issue resolution.
• Documents, tracks, and resolves complaints and inquiries in writing or by phone.
• Supports root cause analysis to identify trends and works cross-functionally for enterprise-wide solutions.
• Coordinates with the contact center to research facts, validate complaints, and evaluate remedies.
• Reviews complaint trends and drafts recommendations to improve member/provider experience and reduce escalations.
• Maintains basic knowledge of Centene products/services to provide accurate customer support.
• Researches basic claims payment errors and makes adjustments when needed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education

High School diploma or GED

Job description

## Escalation Response Specialist IIApply: Remote-FL: Remote-GA: Remote-AZ: Remote-MI: Remote-PA: Full time: Posted Today: 1668742Position Purpose: Assists with responding to complaints and escalations from members/providers. Supports in handling escalations, handling problem tickets, and providing feedback to senior team members regarding member/provider issues. **Key Details:** Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Preferred qualifications include healthcare or health plan experience as well as call center, phone based, and call escalation experience. Medicare experience is preferred. Role requires candidates during peak months (Sept to March) to be able to work Saturdays and Sundays from 8:00 AM-4:30 PM their local time on a rotational schedule. * Provides timely and appropriate resolutions to escalated issues received from various communication channels.* Serves as a liaison in maintaining relationships between departments to ensure timely and appropriate issue resolution.* Supports the documentation, tracking, and resolution to all assigned complaints and inquiries in writing and/or by telephone in a timely and professional manner.* Supports root cause analysis of member/provider issues to identify trends across the enterprise, and works cross functionally with all departments to ensure enterprise-wide solutions.* Helps to coordinate with contact center team to research underlying facts of escalated inquiries, determine validity of complaints and evaluate options to remedy these complaints.* Reviews complaint trends and uses guidance of senior team members to develop draft recommendations that are designed to enhance member and provider experience and reduce complaints and escalations.* Maintains basic, introductory knowledge of our products and services to provide accurate and effective support to customers.* In some instances, researches and identifies basic claims payment errors and make appropriate adjustments.* Performs other duties as assigned.* Complies with all policies and standards.Education/Experience: Requires a High School diploma or GED. Requires 1 – 2 years of related experience. May require vocational or technical education in addition to prior work experience. Vocation or technical education may include additional on-the-job training or continuous learning education.