Remote Member Experience Escalations Lead

TXHB; Northern (KY); Hybrid; USD 60,000 - 90,000; Full time

Job summary

TXHB is seeking a skilled Member Experience Escalation Advocate/Team Lead to resolve complex service escalations and mentor staff. You will investigate issues, coordinate with TPAs and benefit providers, and train teammates to improve the member and employee experience.

The role demands excellence in de-escalation, strong communication, and deep knowledge of TXHB benefits and eligibility rules. Remote work in the US is supported, with standard business hours and potential peak-time coverage.

Qualifications

• Expert knowledge of all TX HB administered benefits, including policies, processes, rules, and regulations.
• Excellent verbal and written communicator, particularly with respect to diffusing irate 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 shifting environment
• Advanced problem solving and critical thinking skills, including the ability to identify 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

Responsibilities

• May supervise the team and manage call queues in the manager’s absence.
• 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.
• Identifies patterns and root causes in escalated calls and works with leadership to implement strategies to reduce the volume of escalated calls
• Identifies process improvements, training gaps and actions around improving the member and employee experience.
• Partners and builds relationships with internal staff and external vendors to resolve member escalations and vendor issues.
• Identifies and proactively manages member and vendor issues, notifying management as needed.
• Effectively handles complex calls, escalated calls and advanced interactions, including ancillary benefit inquiries.

Skills

Benefits knowledge

Communication skills

Section 125 rules

MS Office

Time management

Problem solving

Data trend analysis

Attention to detail

Coaching/mentoring

Tools

Contact center software

Job description

TXHB is seeking a skilled Member Experience Escalation Advocate/Team Lead to resolve complex service escalations and mentor staff. You will investigate issues, coordinate with TPAs and benefit providers, and train teammates to improve the member and employee experience.

The role demands excellence in de-escalation, strong communication, and deep knowledge of TXHB benefits and eligibility rules. Remote work in the US is supported, with standard business hours and potential peak-time coverage.