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About the Role

The Member Experience Escalation Advocate resolves complex service escalation issues for TX HB members and internal stakeholders. This role involves investigating issues, collaborating with third-party administrators, and providing training as a subject matter expert on TX HB benefits. The position requires strong de-escalation and communication skills, with significant autonomy in decision-making.

Responsibilities

• Handles complex and escalated calls, including ancillary benefit inquiries.
• Identifies and manages member and vendor issues, escalating to management when necessary.
• Builds relationships with internal staff and external vendors to resolve member and vendor issues.
• Identifies process improvements and training needs to enhance the member and employee experience.
• Serves as the primary point of contact for TXHB employees needing Member Experience team assistance.
• Identifies trends and root causes in escalated calls to implement strategies for reduction.
• Presents and leads in team huddles and training sessions.
• Assists leadership in maintaining and updating departmental Policies and Procedures.
• Supports the Member Experience Manager in creating training and resource materials.
• Partners with leadership in developing and conducting employee training.
• May supervise the team and manage call queues in the manager’s absence.

Requirements

• Expert knowledge of all TX HB administered benefits, policies, processes, rules, and regulations.
• Excellent verbal and written communication skills, especially in diffusing tense situations.
• Strong knowledge of eligibility requirements, including Section 125 rules.
• Proficient in MS Office, including PowerPoint and Excel.
• Strong time management, organization, and prioritization skills.
• Ability to work effectively in a dynamic environment.
• Advanced problem-solving and critical thinking skills, including trend identification 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.
• Must reside in Texas.
• Office location must be in a quiet, low-traffic area.
• A private, enclosed space with a door is preferred for member confidentiality and privacy compliance.

Skills

• De-escalation
• Communication (Verbal and Written)
• Partnering
• Rapport Building
• Problem Solving
• Critical Thinking
• Time Management
• Organization
• Prioritization
• Attention to Detail
• Coaching
• Mentoring

Location

• Texas

Work Type

• 100% Remote
• Full-time

Experience Level

• Three or more years 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

Education Level

• Associate's degree

About the Company

• The Member Experience team is responsible for resolving complex service escalation issues.