Provider Escalation & Resolution Expert

Zelis Healthcare, LLC; Saint Petersburg (FL); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Zelis Healthcare, LLC seeks a Provider Escalation & Resolution Specialist to deliver exceptional client service and support. You will be the first contact for clients, addressing inquiries, resolving issues, and coordinating with internal teams to ensure a positive experience.

You will handle inquiries via phone, email, and in-person meetings, maintain accurate records, and contribute to improving processes and client satisfaction. Hybrid work arrangement with location flexibility within the U.S.

Qualifications

• 1+ years of customer service experience.
• Healthcare experience is helpful.
• Experience with healthcare escalation tickets is preferred.
• Troubleshoot ticket-related issues and provide timely resolutions.
• Proficiency with AI tools and creating prompts/agents.
• Excellent written and verbal communication.
• Strong problem-solving and conflict resolution skills.
• Ability to work independently and in a team.
• Proficiency in Microsoft Office Suite and CRM software.

Responsibilities

• Respond to client inquiries via phone, email, and in-person meetings in a timely and professional manner.
• Provide accurate information about products, services, and policies.
• Resolve client issues and complaints to ensure satisfaction and retention.
• Manage client accounts and keep information up-to-date.
• Conduct regular check-ins with clients to assess needs and satisfaction.
• Coordinate with internal departments to investigate and resolve issues.
• Escalate complex issues as needed to higher-level support or management.
• Maintain detailed records of client interactions and transactions.
• Prepare and submit regular reports on inquiries, issues, and resolutions.
• Identify trends and provide feedback to improve processes.

Skills

Customer service

Healthcare experience

Escalation tickets

AI tools prompts

CRM software

Communication skills

Tools

CRM software

Microsoft Office

Job description

Zelis Healthcare, LLC seeks a Provider Escalation & Resolution Specialist to deliver exceptional client service and support. You will be the first contact for clients, addressing inquiries, resolving issues, and coordinating with internal teams to ensure a positive experience.

You will handle inquiries via phone, email, and in-person meetings, maintain accurate records, and contribute to improving processes and client satisfaction. Hybrid work arrangement with location flexibility within the U.S.