Description
Position Purpose: Performs as the advocate that focuses on resolving routine inquiries, issues or concerns for members and/or providers. Leverages a variety of communication channels to provide members and/or providers with timely, accurate, and personalized support on routine complaints and escalations.
Key Details: 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.
- Assesses and researches routine member and/or provider inquiries, requests and/or concerns to determines causes, and initiates corrective actions to other service or technical departments for follow up as needed
- Mitigates and prevents complaints from being escalated to resolve in initial contact
- Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
- Provides support on various member or provider issues to ensure customers receive high-quality service
- Maintains performance and quality standards based on established contact center metrics
- Provides customer service in a high pace contact center environment over the phone, via live chats and emails
- Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
- Remains up-to-date and adheres to quality standards, regulations, and all other policies to ensure quality, consistency, and compliance
- Provides expertise in resolving multiple inquiries, requests and/or concern across all areas of responsibilities
- 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. Experience interacting with members and/or providers in a contact center environment preferred.
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
