Complaints and Issues Specialist II

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.

Candidates must live in California.

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...