Escalation Response Specialist

Job Summary

Working remotely on a full-time basis, the Escalation Response Specialist will manage escalated complaints from members and providers, ensuring timely resolutions and maintaining interdepartmental relationships while providing feedback to leadership.

Key responsibilities

• Provide timely and appropriate resolutions to escalated issues from various communication channels
• Document, track, and resolve all assigned complaints and inquiries in writing and/or by telephone
• Conduct root cause analysis of member or provider issues to identify trends and collaborate with departments for enterprise-wide solutions

Required qualifications

• High School diploma or GED required
• 2 - 4 years of related experience preferred
• Vocational or technical education may be required in addition to prior work experience
• Knowledge of Medicare, Medicaid, and Pharmacy is preferred
• Experience with root cause analysis is preferred