Escalation Response Specialist II

Centene Corporation

19h•Remote

About The Position

As a Customer Care professional at Centene, you will have the opportunity to make a significant impact on our 28 million members. Centene is a diversified, national organization that offers competitive benefits and a flexible approach to workplace flexibility. This remote position requires the candidate to be authorized to work in the U.S. without future employment-based visa sponsorship. Experience with Medicare, Medicaid, and prescription drug plans is preferred. The starting hours for this position are between 8:00 am and 10:30 am EST, Monday through Friday.

Requirements

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

Nice To Haves

Experience with Medicare, Medicaid, and prescription drug plans is preferred.
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.

Responsibilities

Assists with responding to complaints and escalations from members/providers.
Supports in handling escalations and problem tickets.
Provides feedback to senior team members regarding member/provider issues.
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 the 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 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 makes appropriate adjustments.
Performs other duties as assigned.
Complies with all policies and standards.