Senior Healthcare Customer Experience & Escalations Lead

Texicare; Texas; Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Automatic 4% employer contribution to

401k plan with 100% match up to 6%

Flexible time off

Nine paid holidays

Day one health, Rx, vision, and dental

Life and disability insurance

Flexible spending account

Pet coverage and pet Rx discounts

Free identity theft protection

Free 2nd medical opinion service

Job summary

Texicare, based in Austin, Texas, seeks a Senior Customer Experience Advocate to act as a subject matter expert for complex member inquiries. You’ll guide benefits interpretation, claims, billing, and provider networks with empathetic communication while ensuring privacy compliance.

You will own complex issues from review to resolution, coordinate with cross-functional teams, and mentor junior agents to uphold service standards. Previous healthcare call center experience is essential.

Qualifications

• A high school diploma or equivalent required; associate or bachelor's degree preferred.
• At least 4 years of experience in a fast-paced call center environment, ideally healthcare customer service.
• Experience supporting multiple communication channels (phone, chat, email).
• Working knowledge of health insurance terminology, claims processing, benefits, and/or provider services preferred.
• Demonstrated leadership skills, including guiding and supporting teammates and daily operations.
• Strong verbal and written communication skills.
• Ability to work in a fast-paced, metric-driven environment.
• Proficiency with computer systems and navigating multiple platforms.

Responsibilities

• Serve as a primary escalation point for complex inquiries across electronic correspondence.
• Oversee lifecycle of complex stakeholder issues, coordinating cross-functional efforts.
• Act as an expert in benefits, policies, claims, and internal processes; guide teammates.
• Identify root causes of recurring issues and partner on process improvements.
• Document all interactions in the CRM system ensuring HIPAA and privacy compliance.
• Provide on-the-job coaching and training support to team members.
• Lead resolution of complex claims and billing discrepancies with cross-department coordination.
• Support onboarding and training initiatives and maintain knowledge resources.

Skills

Call center experience

Healthcare knowledge

Leadership

Communication skills

Multichannel support

HIPAA awareness

Education

High school diploma

Associate or Bachelor's preferred

Job description

Texicare, based in Austin, Texas, seeks a Senior Customer Experience Advocate to act as a subject matter expert for complex member inquiries. You’ll guide benefits interpretation, claims, billing, and provider networks with empathetic communication while ensuring privacy compliance.

You will own complex issues from review to resolution, coordinate with cross-functional teams, and mentor junior agents to uphold service standards. Previous healthcare call center experience is essential.