Remote Healthcare Escalation Specialist II

Centene Corporation; Enid (OK); Hybrid; USD 38,000 - 52,000; Full time

Job summary

Centene Corporation is seeking an customer-service oriented professional to assist with complaints and escalations from members and providers. The role requires working Saturdays and Sundays during peak months and offers a flexible schedule across remote, hybrid, field or office settings.

Responsibilities include researching inquiries, coordinating with departments, and tracking resolutions. A high school diploma or GED and 1–2 years of related experience are required, with healthcare/health

Qualifications

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

Responsibilities

• Provide timely and appropriate resolutions to escalated issues from members/providers.
• Serve as liaison between departments to ensure timely issue resolution.
• Support documentation, tracking and resolution of complaints and inquiries in writing or by telephone.
• Support root cause analysis of member/provider issues and work cross-functionally to implement enterprise-wide solutions.
• Coordinate with contact center to research underlying facts of escalated inquiries and evaluate options to remedy complaints.
• Review complaint trends and draft recommendations to improve member/provider experience and reduce escalations.
• Maintain basic knowledge of Centene products and services to provide accurate support.
• Research basic claims payment errors and make appropriate adjustments when needed.
• Perform other duties as assigned and comply with policies and standards.

Education

High School diploma or GED

Job description

Centene Corporation is seeking an customer-service oriented professional to assist with complaints and escalations from members and providers. The role requires working Saturdays and Sundays during peak months and offers a flexible schedule across remote, hybrid, field or office settings.

Responsibilities include researching inquiries, coordinating with departments, and tracking resolutions. A high school diploma or GED and 1–2 years of related experience are required, with healthcare/health