Healthcare Escalation Specialist (Bilingual Spanish)

100% remote position for Texas residents only.

About The Role

We're seeking an experienced Healthcare Escalation Specialist to resolve complex member service issues and benefit-related concerns. This role serves as a subject matter expert, partnering with members, internal teams, carriers, and vendors to investigate issues, drive resolution, and deliver an exceptional member experience.

Responsibilities

• Handle complex member inquiries and escalated service issues
• Investigate enrollment, eligibility, COBRA, and benefit-related concerns
• Resolve issues involving medical, dental, vision, and pharmacy benefits
• Partner with internal teams, carriers, and vendors to ensure timely resolution
• De-escalate challenging situations with professionalism and empathy
• Identify root causes and recommend process improvements
• Maintain accurate documentation of interactions and resolutions
• Support training, mentoring, and knowledge-sharing initiatives

Requirements

• Bilingual Spanish/English required
• 3+ years of contact center experience, including 2+ years in healthcare or health insurance
• 1+ year of experience handling escalated customer or member issues
• 1+ year as a Team Lead, SME, Mentor, Escalation Specialist, or Supervisor
• Knowledge of healthcare benefits, eligibility, enrollment, and COBRA
• Strong problem-solving, conflict-resolution, and communication skills
• Proficiency with Windows, Microsoft Word, and Excel
• Typing speed of 40+ WPM with 80% accuracy
• Experience working successfully in a remote environment
• High School Diploma or GED required
• Must reside in Texas

Work-From-Home Requirements

• Dedicated, private workspace
• Reliable high-speed internet (200 Mbps download / 25 Mbps upload minimum)

Training

• 4 weeks paid, fully remote
• Monday-Friday, 8:00 AM - 5:00 PM CST

Schedule

Monday-Friday, 8:00 AM - 5:00 PM CST

Pay

The pay range for this position is $22.64 - $22.64/hr.

Benefits

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Why Join Us?

• 100% remote opportunity
• No nights or weekends
• Supportive leadership and team environment
• Opportunities for growth within healthcare operations and leadership

This is a Contract to Hire position based out of Houston, TX.