($17.17 - $26.97 per hour) Complaints and Issues Specialist II -Remote
Description
You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Documents and addresses customer complaints and issues (I.e., grievances, appeals, Claims Tracking Module) based on regulatory requirements. Supports and collaborates with team members and other functions to document and identify a compliant solution for complaints and issues.
- Processes all received customer inquiries, complaints, and issues using internal tools as defined by the state and federal regulatory requirements
- Documents written issues and responses related to customer inquiries, complaints, and issues to ensure regulatory compliance
- Supports the investigation of complaints and issues to determine root cause and identify appropriate resolution
- Collaborates with internal stakeholders to ensure timely and effective resolution of customer inquiries, complaints, and issues to adhere to quality standards, regulations, and confidentiality
- Supports the development and implementation of policies and procedures for handling customer inquiries, complaints, and issues
- Supports in analyzing complaints and issues data to identify trends and opportunities for improvement
- Runs standard reports for management on the status of customer inquiries, complaints, and issues and to support ad-hoc requests
- Maintains monthly summary of open cases with to comply with all state and federal regulatory requirements
- Supports development of materials to train contact center staff on customer inquiries, complaints, and issues resolution and documentation
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a High School diploma or GED
Requires 1 – 2 years of related experience. 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
Ability to prioritize, perform independent decision making, and manage time effectively preferred.Pay Range: $17.17 - $26.97 per hour