Intermediate / Senior Customer Experience Advocate

Texicare•TX, TX

11d•Remote

About The Position

We are growing our Customer Experience team by hiring our first team members to join our Manager of Customer Experience internally at Texicare. As a Customer Experience Advocate, you will play a critical role in delivering exceptional service and shaping the overall experience of our customers. You will serve as a trusted point of contact for stakeholder inquiries, guiding members through benefits, claims, and provider networks with clarity and care. From resolving routine questions to navigating more complex issues, you will ensure each interaction is handled with accuracy, empathy, and a strong sense of ownership. In this role, you will manage the end-to-end lifecycle of inquiries—identifying root causes, ensuring timely resolution, and documenting interactions to support a seamless and compliant customer experience. As you grow in the role, you will deepen your expertise and take on increasingly complex issues, contributing to process improvements and helping to prevent recurring challenges. At the senior level, you will expand your impact as a subject matter expert and escalation point, leading the resolution of complex or sensitive issues while partnering cross-functionally to drive meaningful improvements. You will serve as a mentor and resource to team members, modeling best-in-class service delivery and supporting team development through coaching and knowledge sharing. We’re looking for a detail-oriented, service-driven professional who brings strong problem-solving skills, sound judgment, and a commitment to continuous improvement. You thrive in a fast-paced environment, proactively identify opportunities to enhance the customer experience, and are motivated to make a meaningful impact. If you’re passionate about advocacy, collaboration, and delivering high-quality service, we’d love to connect with you.

Requirements

A high school diploma or equivalent required; Associate or Bachelor’s degree preferred.
Experience working in a fast-paced call center environment, ideally in healthcare customer service. You should have at least 2 years of related work experience for the intermediate role and 4 years for the senior role.
Experience supporting multiple communication channels (phone, chat, email).
Working knowledge of health insurance terminology, claims processing, benefits, and/or provider services preferred.
Strong verbal and written communication skills.
Demonstrated ability to work in a fast-paced, metrics-driven environment.
Proficiency with computer systems and ability to navigate multiple platforms simultaneously.

Nice To Haves

Bilingual in English and Spanish.
Previous experience in a HIPAA-regulated environment.

Responsibilities

Respond to inquiries from members, providers, and brokers, delivering timely, accurate, and high-quality service. Phone will be the primary channel of communication, with some use of email and chat as well.
Manage the end-to-end lifecycle of inquiries, ensuring clear communication, thorough follow-up, and complete resolution.
Research and resolve issues related to benefits, eligibility, claims status, billing discrepancies, and cost-sharing.
Interpret plan documents, policies, and internal guidelines to provide clear and accurate guidance.
Initiate and track claims adjustments, reprocessing, or escalations in accordance with established procedures.
Identify root causes of issues, address underlying needs, and recommend process improvements.
Document all interactions in the CRM system (Salesforce) in compliance with HIPAA, privacy, and audit requirements.
Collaborate with cross-functional teams to validate data, resolve issues, and address systemic challenges.
Serve as an escalation point for complex or sensitive inquiries, ensuring effective and timely resolution.
Act as a subject matter expert, providing guidance on complex benefits, claims, and policy scenarios.
Lead cross-functional coordination to resolve high-impact issues and drive sustainable solutions.
Mentor and support team members through coaching, training, and knowledge sharing.
Contribute to quality assurance and continuous improvement efforts, modeling best-in-class service delivery.