Healthcare Support Advocate

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XO Health Inc.

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

XO Health Inc. is a company that provides comprehensive, tech-enabled health benefit solutions specifically designed for the self-insured market. Their services cater to self-insured employers, brokers and consultants, and third-party administrators, aiming to unify the healthcare experience. XO Health offers a value-based provider network, member advocacy and care navigation, integrated medical and pharmacy plans, and employer stop-loss coverage. Their solutions are focused on balancing cost and quality, providing flexible and tailored healthcare solutions for employers.

📋 Description

• Handle inbound and outbound member and provider inquiries via phone, email, and chat • Initiate member outreach regarding benefits • Provide information on benefits, eligibility, coverage, claims, prior authorization, billing, reimbursement policies, and provider portal support • Resolve inquiries, complaints, grievances, and escalations with complete documentation and proper routing • Conduct follow-up outreach to ensure resolution, satisfaction, and continuity of care or claim outcomes • Build trust through early, frequent, and personalized engagement • Collaborate with Claims Operations, Network Operations, and Account Management teams on complex cases and service improvements • Identify recurring issues, system gaps, and process inefficiencies and provide feedback to leadership • Meet goals for efficiency, productivity, quality, accuracy, customer satisfaction, compliance, follow-up completion, and attendance • Maintain confidentiality and compliance with HIPAA, ERISA, and XO Health policies

🎯 Requirements

• 3–5 years of experience in a healthcare payer, TPA, or health insurance environment, including contact center/member-provider support • Strong knowledge of health insurance concepts, benefits and eligibility, medical terminology, and claims lifecycle management • Strong English verbal and written communication skills • High attention to detail, sound judgment, and analytical problem-solving skills • Ability to multitask in a fast-paced, digital-first environment while maintaining accuracy and professionalism • Proficiency in Microsoft Office Suite and customer service and/or claims processing systems • Must support contact center hours of 8:00am–5:30pm ET • Must participate in a rotating on-call schedule for urgent member and provider support • Preferred: Associate or bachelor’s degree in healthcare administration, business, or related field • Preferred: Familiarity with Availity Essentials, payer portals, and EDI standards • Preferred: Familiarity with Genesys, ServiceNow, and other CRM tools • Preferred: Familiarity with Facility, Physician, Ancillary, and Behavioral Health claim types • Spanish proficiency is a plus