Member Experience Escalation Advocate – Team Lead

🕒 August 15

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟠 Senior

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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TX Health Benefits Pool

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1979

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

TX Health Benefits Pool is dedicated to serving the healthcare needs of political subdivisions in Texas. It recognizes the impact of today's economy and the challenges faced by its members. The organization is committed to bringing members together to ensure quality healthcare benefits for employees and families at an exceptional value.

📋 Description

• Resolve highly complex service escalations from TX HB members, Benefit Coordinators, Member Service Advocates, Marketing staff, and other internal stakeholders • Investigate service issues and work with third-party administrators and benefit service providers to resolve issues promptly • Handle complex calls, escalated calls, advanced interactions, and ancillary benefit inquiries • Identify and proactively manage member and vendor issues, notifying management as needed • Build relationships with internal staff and external vendors to resolve escalations and vendor issues • Identify process improvements, training gaps, and actions to improve member and employee experience • Serve as the primary contact for TXHB employees needing Member Experience assistance • Identify patterns and root causes in escalated calls and work with leadership to reduce escalation volume • Present and lead team huddles and training sessions • Assist leadership with maintaining and updating departmental policies and procedures • Support the Member Experience Manager in creating training and resource materials • Partner with leadership to develop and conduct contractor and employee training • May supervise the team and manage call queues in the manager's absence

🎯 Requirements

• Associate's degree required • Three or more years of experience in a contact center environment • At least two years of experience in a health insurance/healthcare-related contact center • One or more years of experience handling escalated calls • Expert knowledge of TX HB-administered benefits, including policies, processes, rules, and regulations • Strong knowledge of eligibility requirements, including Section 125 rules • Proficiency in Microsoft Office, including PowerPoint and Excel • Strong time management, organization, and prioritization skills • Ability to work effectively in a shifting environment • Advanced problem-solving and critical-thinking skills, including identifying trends in data • Strong attention to detail and ability to prioritize and organize workload • Advanced knowledge of contact center software and tools • Ability to coach and mentor staff • Excellent verbal and written communication skills, particularly for diffusing irate situations • Preferred: graduation from an accredited four-year college or university with coursework in business administration, insurance, or a related field • Experience and education may be substituted for one another • Private, enclosed workspace with a door preferred for member confidentiality and privacy compliance • Ability to speak and hear clearly; frequently stand, sit, and walk; lift or move up to 15 pounds; work for prolonged periods at a desk and computer

🏖️ Benefits

• 100% remote work, Monday-Friday • Monday-Friday work schedule, 8:00 AM-5:00 PM • Flexible scheduling during peak times, with possible non-standard hours • Reasonable accommodations may be made for individuals with disabilities