Escalation Response Specialist II - Remote Impact

Centene Corporation; Florida; Ibrido; USD 36.000 - 56.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

401K plans

Stock purchase program

Tuition reimbursement

Paid time off & holidays

Remote/Hybrid flexible schedules

Descrizione del lavoro

Centene Corporation is seeking a detail-oriented Escalations Specialist to respond to complaints and escalations from members and providers. The role supports cross-functional teams to resolve issues, document findings, and identify root causes to prevent recurrences.

The successful candidate will have 1–2 years of related experience, preferably in healthcare or health plans, and some call-center exposure. Flexible schedules including weekends during peak season are possible, with multiple work

Competenze

• 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.
• Healthcare or health plan experience preferred.
• Call center, phone-based, and call escalation experience preferred.
• Medicare experience preferred.

Mansioni

• 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.

Conoscenze

Call center experience

Escalation handling

Healthcare/health plan experience

Communication skills

Formazione

High School diploma or GED

Descrizione del lavoro

Centene Corporation is seeking a detail-oriented Escalations Specialist to respond to complaints and escalations from members and providers. The role supports cross-functional teams to resolve issues, document findings, and identify root causes to prevent recurrences.

The successful candidate will have 1–2 years of related experience, preferably in healthcare or health plans, and some call-center exposure. Flexible schedules including weekends during peak season are possible, with multiple work