Member Experience Escalation Advocate – Team Lead
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Job Description
Member escalation lead resolving complex health benefits issues for TX HB members. Investigating vendor problems, improving processes, and coaching contact center staff remotely.
Responsibilities:
- 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
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