Senior Customer Experience Advocate

Texicare•TX, TX

3d•Hybrid

About The Position

The Senior Customer Experience Advocate serves as a subject matter expert and escalation point for complex member and stakeholder inquiries. The role helps people understand benefits, coverage, claims, billing, and provider networks through sound judgment and clear, empathetic communication. It owns complex issues from initial review through resolution, coordinating with operational and support teams, keeping stakeholders informed, and ensuring accurate, timely follow-through. The position interprets plan documents, investigates claims and billing discrepancies, and maintains thorough CRM documentation in accordance with privacy and compliance standards. The Senior Customer Experience Advocate also serves as a trusted resource and team lead for customer advocates by providing real-time guidance, coaching, quality feedback, and support for onboarding and training. The role identifies recurring issues and partners with leaders and cross-functional teams to improve processes, address root causes, and prevent future challenges. Texicare offers a flex-hybrid environment centered around collaboration and connection. Employees must reside in Texas. Team members in the Austin area are expected to work from the office at least two days per week; those outside the greater Austin area may work remotely within Texas, with occasional travel to Austin as needed.

Requirements

High school diploma or equivalent required.
At least 4 years of experience in a fast-paced call center environment, ideally in healthcare customer service.
Experience supporting multiple communication channels, such as phone, chat, and email.
Demonstrated leadership skills, including guiding and supporting teammates, contributing to daily team operations, and helping advance department priorities.
Strong verbal and written communication skills.
Ability to work in a fast-paced, metric-driven environment.
Proficiency with computer systems and ability to navigate multiple platforms simultaneously.
A quiet, dedicated workspace free from distraction.
Must reside in Texas.

Nice To Haves

Associate or bachelor's degree.
Working knowledge of health insurance terminology, claims processing, benefits, and/or provider services.
Bilingual in English and Spanish.
Previous experience in a HIPAA-regulated environment.

Responsibilities

Serve as a primary escalation point for complex or sensitive stakeholder inquiries across electronic correspondence, ensuring high-quality resolution and exceptional service delivery.
Oversee complex stakeholder issues from initial discovery through final resolution, coordinating cross-functional efforts, ensuring timely follow-up, and maintaining clear, proactive communication.
Act as an expert in benefits, policies, claims, and internal processes, providing guidance to team members and stakeholders on nuanced or high-impact scenarios.
Identify root causes of recurring issues, recommend and influence process improvements, and partner with leadership to implement solutions that enhance the customer experience.
Document customer interactions in the CRM system to support a seamless member experience and satisfy HIPAA, privacy, and internal regulatory audit standards.
Analyze and interpret complex plan documents to provide guidance on eligibility, coverage, and cost-sharing.
Lead resolution of complex claims and billing discrepancies, including initiating and tracking escalations, reprocessing, and cross-departmental coordination.
Partner with operational and support teams to identify systemic issues, validate data integrity, and ensure sustainable resolution of identified gaps.
Serve as the team lead and go-to resource for customer advocates, providing real-time support, coaching, and mentorship.
Support onboarding and ongoing training; develop and maintain knowledge resources, best practices, and processing documentation.
Model high-quality service delivery and support quality assurance by reviewing interactions, providing feedback, and reinforcing team service standards.