The Contact Center Escalation Specialist is responsible for investigating, documenting, and resolving complex member and provider complaints within Harbor Health's contact center.
Requirements
- 1–2 years of experience in member services or provider services within a healthcare environment
- Comprehensive understanding of health insurance plan processes: claims, appeals, grievances, and prior authorizations
- Proficiency in healthcare compliance standards and internal policies related to complaint management (HIPAA, CMS, TDI)
- Exceptional written and verbal communication; ability to manage sensitive member issues with professionalism
- Strong research, analysis, and problem-solving skills to identify root causes and implement effective resolutions
- Competency maintaining records in CRM or complaint management software
- Ability to collaborate effectively with Legal, QA, and Operations teams
Benefits
- Competitive salary and benefits package
- Professional development and growth opportunities as the team scales
- A transparent startup culture with direct access to leadership