Position Purpose:
Performs as the advocate that focuses on resolving complex issues or concerns for members or providers. Leverages a variety of communication channels to provide members or providers with timely, accurate, and personalized resolutions on complex complaints and escalations.
Education/Experience:
Requires 4+ 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
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
College, vocation, or technical education may include additional on-the-job training or continuous learning education preferred.
Assesses and researches customer service needs, determines causes, and initiates corrective actions to other service or technical departments for follow up as needed
Provides guidance on various complex member or provider issues to resolve customer’s inquiries or requests
Provides member or providers with information and resources to further educate relevancy to the complex inquiry or concern
Provides customer service in a high pace contact center environment over the phone, via live chats and emails
Continues to develop in-depth knowledge and deep expertise in multiple additional markets and/or plans in multiple subject areas and responds to complex or escalated questions
May lead the team in member or provider request resolution and collaborates inter- departmentally to resolve inquiries or concerns
Identifies, documents and resolves all customer information and communications and updates leadership on customer needs thru root cause analysis, recommendation and resolution
Collaborates with training teams to develop training materials and/or programs to ensure quality and adherences to policies and procedures
Records all activities for quality and metrics ing through the Customer Relationship Management (CRM) application, including customer interactions, details of inquiries, complaints, comments, and final resolution
Adheres to quality standards, regulations, and confidentiality through the various communication channels
Participates in special projects as needed.
Performs other duties as assigned
Complies with all policies and standards
**Must reside in Oklahoma
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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