About the job

At MSH, passion meets profession. We're a team of dedicated enthusiasts who find genuine fulfillment in what we do - and we're looking for someone who feels the same way.

About the Role

As a Case Resolution Specialist, you will play a key role in delivering exceptional service by investigating complex claims issues and resolving customer disputes. Acting as the primary point of contact for escalated cases, you will work closely with members, internal teams, and leadership to ensure concerns are addressed fairly, efficiently, and in line with company policies.This role combines strong analytical abilities with a customer-focused approach. Beyond resolving individual cases, you will identify trends, recommend process improvements, and help enhance the overall member experience.

• What You'll DoInvestigate and Resolve ComplaintsConduct thorough investigations into escalated complaints from members, call centers, and account management teams.
• Gather, review, and analyze information to determine the validity of disputes and identify root causes.
• Document findings accurately and maintain complaint records in accordance with established procedures.
• Manage cases from initial review through final resolution, ensuring timely follow-up and closure.
• Collaborate Across TeamsPartner with Claims Adjudicators, Quality Assurance, Accounting, and Account Management teams to develop fair and effective resolutions.
• Review proposed corrective actions with Supervisors, Senior Team Members, and the Claims Manager before implementation.
• Ensure all stakeholders are informed through clear and proactive communication throughout the resolution process.
• Drive Continuous ImprovementIdentify recurring issues and service gaps that contribute to customer complaints.
• Recommend process improvements and corrective actions to enhance service quality and operational efficiency.
• Present recommendations and findings to Claims Management and senior leadership for approval.
• Support Team SuccessProvide guidance and support to junior team members on processes and best practices.
• Assist with claims processing and administrative activities during high-volume periods.
• Contribute to a collaborative team environment focused on delivering outstanding customer
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