Complaints and Issues Specialist II

Are you a detail-oriented problem solver who loves uncovering facts, piecing together information, and helping people? We are seeking a dedicated Complaints and Issues Specialist to join our fast-paced, collaborative team. In this exciting remote role, you will be on the front lines of member advocacy, reviewing social media inquiries, researching complex cases, and ensuring members and healthcare providers receive timely, compliant resolutions.

If you thrive in a dynamic environment where no two days are the same, love solving mysteries, and want to gain valuable exposure to healthcare compliance, member advocacy, and social media operations, this is the perfect opportunity for you. You will work from home while receiving full operational support and collaborating closely with cross-functional teams to make a real impact during peak enrollment periods.

salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Position Summary:

Review, research, and process member and provider inquiries submitted via social media platforms and internal tools. Retrieve case documentation, investigate root causes, coordinate with internal stakeholders, and ensure full compliance with regulatory standards.

Key Responsibilities:

• Monitor social media platforms to review, research, and respond to incoming inquiries and complaints.

• Retrieve, organize, and assemble complete case documentation from multiple internal repositories for analyst review.

• Conduct outbound phone calls to members, providers, and internal partners to gather missing documentation or information.

• Collaborate with Customer Service, Appeals & Grievances, Compliance, and Operations teams to ensure compliant, timely resolutions.

• Track case inventory, index supporting documents, and document all interactions accurately.

Requirements:

• High School Diploma or GED required (Bachelor's degree preferred).

• 1–2 years of related experience in administrative operations, document management, research, or data retrieval.

• strong written and verbal communication skills; comfortable conducting outbound calls to members and providers.

• High proficiency in Microsoft Office applications.

• Preferred: Prior experience with corporate social media management platforms or healthcare operations.

Skills

• Responsiveness
• Analytical Thinking
• Written Communication
• General Accounting and Finance Skills

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.