Escalations Specialist

GeoBlue has created a new department within the Operations team! This enterprise-wide support team will advance our capabilities in monitoring, analyzing, and responding to customer feedback. The Customer Response Team is currently seeking the following positions: Customer Response Team Manager, Escalations Program Lead and 2 Escalation Specialists.

The Escalations Specialist reports to the Customer Response Team Manager and is salary grade EA 41 with a minimum base salary of $56,243. Internal applicants can further discuss compensation details with the Talent Discovery Partner.

The Escalations Specialist is responsible for investigating and resolving member concerns received through various feedback channels, including surveys, social media, and direct outreach. This role requires a strong commitment to enhancing the customer experience and the ability to navigate complex issues with empathy, professionalism, and precision. The Escalation Specialist will also support the resolution of escalated and intricate member issues by conducting thorough research and ensuring timely, accurate responses. This role involves direct outreach to members or providers to facilitate resolution and deliver a positive customer experience.

Responsibilities:

• Monitor, triage, and respond to member feedback submitted via surveys, social media platforms, and other channels
• Conduct thorough research into escalated concerns, collaborating with internal departments (Claims, Service, Clinical) to gather context and resolve issues
• Craft clear, compassionate, and timely responses to members, ensuring their concerns are acknowledged and addressed appropriately
• Identify trends and recurring issues and escalate systemic problems to the appropriate teams for resolution
• Maintain accurate records of all escalations, actions taken, and outcomes in accordance with compliance and privacy standards
• Partner with Operations leaders, the Customer Experience team and other stakeholders to improve processes and reduce future escalations
• Contribute to regular reporting on escalation volumes, resolution times, and member sentiment insights
• Ensure compliance with HIPAA regulations including required confidentiality

• At least 2 years of experience in claims, customer service, member relations, or issue resolution, preferably in a health insurance or healthcare setting
• Strong written and verbal communication skills, with a focus on empathy and clarity
• Experience handling sensitive or complex customer issues with discretion and professionalism
• Familiarity with social media platforms and customer feedback tools
• Ability to work cross-functionally and manage multiple priorities in a fast-paced environment
• Passion for improving customer experience and satisfaction
• Excellent listening, verbal, written, and telephone etiquette business communication skills
• Strong analytical, problem-solving skills, organization and time management skills
• Proficient with Microsoft Office products and Salesforce Health Cloud
• Solid understanding of telephony hardware and software applications is a plus