Provider Escalation & Resolution Specialist

Zelis Healthcare, LLC
18.75/hr
United States, Florida, St. Petersburg
570 Carillon Parkway (Show on map)
Oct 09, 2026
The Provider Escalation & Resolution Specialist will be responsible for providing exceptional customer service and support to clients. This role involves addressing client inquiries, resolving issues, and ensuring a positive client experience. The Provider Escalation & Resolution Specialist will serve as the first point of contact for clients and will work closely with other team members to deliver high-quality service. What You'll Do: Respond to client inquiries via phone, email, and in-person meetings in a timely and professional manner. Provide accurate information and assistance to clients regarding products, services, and policies. Requires knowledge of the Zelis products and services. Resolve client issues and complaints efficiently, ensuring client satisfaction and retention. Manage client accounts, ensuring all client information is up-to-date and accurate. Conduct regular check-ins with clients to assess their needs and satisfaction levels. Investigate and resolve client issues by coordinating with internal departments. Escalate complex issues to higher-level support or management as needed. Follow up with clients to ensure their issues are resolved and they are satisfied with the service. Maintain detailed and accurate records of client interactions and transactions. Prepare and submit regular reports on client inquiries, issues, and resolutions. Identify trends in client issues and provide feedback to improve processes and services. Stay updated on company products, services, and policies. Provide clients with information on new products and services that may meet their needs. Participate in team meetings and contribute to the development of client service strategies and high-quality client service experience. Support other team members during peak times or when additional help is needed. What You'll Bring to Zelis: 1+ yrs customer service experience. Healthcare experience helpful. Experience working with healthcare escalation tickets is preferred. Troubleshoot ticket-related issues and provide timely and effective resolutions preferred. Requires proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents. Excellent written and verbal communication skills. Strong problem-solving and conflict resolution skills. Ability to work independently and as part of a team. Proficiency in Microsoft Office Suite and customer relationship management (CRM) software.