Member Experience Escalation Advocate – Team Lead

This is a fully remote position, open to applicants in Texas.

📋 Description

• Address and resolve intricate service escalations from TX HB members, Benefit Coordinators, Member Service Advocates, Marketing personnel, and other internal stakeholders.

• Conduct investigations into service issues and collaborate with third-party administrators and benefit service providers to ensure prompt resolutions.

• Manage complex and escalated calls, advanced interactions, and inquiries related to ancillary benefits.

• Proactively identify and manage member and vendor concerns, escalating to management when necessary.

• Foster relationships with internal teams and external vendors to effectively resolve escalations and vendor-related issues.

• Recognize opportunities for process improvements, training deficiencies, and actions aimed at enhancing member and employee experiences.

• Act as the main point of contact for TXHB employees seeking assistance with Member Experience.

• Detect patterns and root causes in escalated calls, collaborating with leadership to decrease escalation rates.

• Lead and present during team huddles and training sessions.

• Assist leadership in maintaining and updating departmental policies and procedures.

• Support the Member Experience Manager in the development of training and resource materials.

• Collaborate with leadership to design and deliver training for contractors and employees.

• May supervise the team and oversee call queues during the manager's absence.

⛳️ Requirements

• An associate's degree is required.

• A minimum of three years of experience in a contact center environment.

• At least two years of experience within a health insurance or healthcare-related contact center.

• One or more years of experience in managing escalated calls.

• In-depth knowledge of TX HB-administered benefits, including relevant policies, processes, rules, and regulations.

• Strong understanding of eligibility requirements, notably Section 125 regulations.

• Proficiency with Microsoft Office applications, including PowerPoint and Excel.

• Excellent skills in time management, organization, and prioritization.

• Capability to thrive in a dynamic environment.

• Advanced problem-solving and critical-thinking skills, particularly in identifying trends within data.

• Exceptional attention to detail alongside the ability to prioritize and manage workload effectively.

• Advanced knowledge of contact center software and tools.

• Competence in coaching and mentoring staff members.

• Outstanding verbal and written communication skills, especially in de-escalating tense situations.

• Preferred: graduation from an accredited four-year college or university with coursework in business administration, insurance, or a related discipline.

• Experience and education may be interchangeable.

• A private, enclosed workspace with a door is preferred to ensure member confidentiality and privacy compliance.

• Ability to communicate clearly and audibly; frequently stand, sit, and walk; lift or move up to 15 pounds; and work for extended periods at a desk and computer.

🏝️ Benefits

• 100% remote work available, Monday through Friday.

• Work schedule from Monday to Friday, 8:00 AM to 5:00 PM.

• Flexible scheduling options during peak periods, including potential non-standard hours.

• Reasonable accommodations may be provided for individuals with disabilities.