Remote Executive Escalation & Resolution Specialist II

Centene Corporation; Florida; Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

Health insurance

401K plan

Stock purchase plan

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a Customer Escalation Specialist in Florida to respond to complaints and escalations from members and providers. You will coordinate with multiple departments to resolve issues, perform root cause analysis, and maintain accurate records of all inquiries.

The role requires strong communication skills, familiarity with Medicare/Medicaid processes, and the ability to work across teams to implement enterprise-wide solutions.

Qualifications

• Requires a High School diploma or GED and 1–2 years of related experience.
• Strong written and verbal communication skills; experience managing executive-level escalations.
• Medicare and Medicaid knowledge preferred.
• Root cause analysis experience helpful.
• Sponsorship is not available for this opportunity.

Responsibilities

• Provides timely and appropriate resolutions to escalated issues from members/providers.
• Acts as liaison between departments to ensure timely and appropriate issue resolution.
• Supports documentation, tracking, and resolution of complaints and inquiries by writing or calling.
• Performs root cause analysis of member/provider issues to identify enterprise-wide trends.
• Coordinates with contact center to research underlying facts of escalated inquiries and evaluate remediation options.
• Reviews complaint trends and drafts recommendations to improve member/provider experience and reduce escalations.
• Maintains basic knowledge of Centene products and services to provide accurate support.
• Researches and identifies basic claims payment errors and makes appropriate adjustments when needed.
• Other duties as assigned and ensures compliance with policies and standards.

Skills

Escalation management

Communication skills

Medicare knowledge

Root cause analysis

Customer service

Education

High School diploma or GED

Job description

Centene Corporation is seeking a Customer Escalation Specialist in Florida to respond to complaints and escalations from members and providers. You will coordinate with multiple departments to resolve issues, perform root cause analysis, and maintain accurate records of all inquiries.

The role requires strong communication skills, familiarity with Medicare/Medicaid processes, and the ability to work across teams to implement enterprise-wide solutions.