Remote Member Experience Escalation Lead

TX Health Benefits Pool; Austin (TX); On-site; USD 75,000 - 110,000; Full time

Job summary

TX Health Benefits Pool is seeking a Member Experience Escalation Advocate/Team Lead to resolve highly complex service escalations from members, Benefit Coordinators, Member Service Advocates, Marketing staff and other TX HB stakeholders. The role investigates issues and coordinates with TPAs or other providers to resolve them promptly while mentoring staff.

You will de‑escalate irate members, communicate effectively in writing and speech, and build strong cross‑department partnerships to

Qualifications

• Three or more years in a contact center environment including at least two years of experience in a health insurance/healthcare related contact center.
• One or more years of experience handling escalated calls.
• Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is generally preferred. Experience and education may be substituted for one another.
• Two years of experience working at TX HB.

Responsibilities

• Effectively handles complex calls, escalated calls and advanced interactions, including ancillary benefit inquiries.
• Identifies and proactively manages member and vendor issues, notifying management as needed.
• Partners and builds relationships with internal staff and external vendors to resolve member escalations and vendor issues.
• Identifies process improvements, training gaps and actions around improving the member and employee experience.
• Serves as the primary point of contact for TXHB employees that require Member Experience team assistance.
• Identifies patterns and root causes in escalated calls and works with leadership to implement strategies to reduce the volume of escalated calls
• Presents and leads in team huddles and training sessions.
• Assists leadership team in maintaining and updating departmental Policies and Procedures.
• Supports Member Experience Manager in creating training materials and resource materials
• Partners with leadership in developing and conducting contractor and employee training.
• May supervise the team and manage call queues in the manager’s absence.

Skills

Escalation handling

De‑escalation

Verbal & written communication

Vendor coordination

MS Office (Excel/PowerPoint)

Time management

Policy knowledge

Staff coaching/mentoring

Education

Bachelor’s degree in business administration, insurance, or related field

Tools

Call center software

CRM systems

MS Office (Excel/PowerPoint)

Job description

TX Health Benefits Pool is seeking a Member Experience Escalation Advocate/Team Lead to resolve highly complex service escalations from members, Benefit Coordinators, Member Service Advocates, Marketing staff and other TX HB stakeholders. The role investigates issues and coordinates with TPAs or other providers to resolve them promptly while mentoring staff.

You will de‑escalate irate members, communicate effectively in writing and speech, and build strong cross‑department partnerships to