Healthcare Support Advocate

XO Health is the first health plan designed by and for self-insured employers, delivering a unified health experience for members, providers, and payers. Join our multi-disciplinary team of diverse, digitally empowered employees rebuilding trust in healthcare through comprehensive transformation.

About the Role

As a Healthcare Support Advocate, you will be a key member of XO Health’s operations team, supporting both member and provider services through our virtual contact center. This role serves as the primary point of contact for members and providers via phone, email, and chat, requiring a service-first mindset, high attention to detail, and the ability to balance real-time support with operational tasks. You will collaborate cross-functionally to ensure timely, compliant, and high-quality support.

Responsibilities

• Handle inbound and outbound member and provider inquiries via phone, email, and chat with professionalism and empathy.
• Initiate member outreach to provide information and assistance regarding benefits.
• Provide accurate information on benefits, eligibility, coverage, claims status, prior authorization, billing, reimbursement policies, and provider portal navigation.
• Resolve inquiries, complaints, grievances, and escalations with complete documentation and proper routing when needed.
• Conduct follow-up outreach to ensure resolution, satisfaction, and continuity of care or claim outcomes.
• Build trust with members and providers through early, frequent, and personalized engagement.
• Collaborate with Claims Operations, Network Operations, and Account Management teams to resolve complex cases and improve service delivery.
• Identify recurring issues, system gaps, or process inefficiencies and provide feedback to leadership.
• Meet performance goals for efficiency, productivity, quality, customer satisfaction, compliance, follow-up completion, and attendance.
• Maintain confidentiality and compliance with HIPAA, ERISA, and XO Health policies.

Requirements

• 3–5 years of experience in a healthcare payer, TPA, or health insurance environment, with a blend of contact center/member-provider support.
• Strong knowledge of health insurance concepts, benefits and eligibility, medical terminology, and claims lifecycle management.
• Excellent English language verbal and written communication skills, with an empathetic, solution-oriented approach.
• High attention to detail, sound judgment, and strong analytical problem-solving skills.
• Ability to multitask in a fast-paced, digital-first environment while maintaining accuracy and professionalism.
• Proficiency in Microsoft Office Suite and customer service and/or claims processing systems.

Skills

• Associate or bachelor’s degree in healthcare administration, business, or a related field (preferred).
• Familiarity with Availity Essentials, payer portals, and EDI standards (preferred).
• Experience with Genesys, ServiceNow, or other CRM tools (preferred).
• Knowledge of Facility, Physician, Ancillary, and Behavioral Health claim types (preferred).
• Spanish language proficiency (written and verbal) is a plus.

Schedule

• Must be available to support contact center hours of 8:00 AM – 5:30 PM ET.
• Must participate in a rotating on-call schedule for urgent member and provider support needs.

Pay

$55,000—$75,000 USD (based on candidate experience and relevant certifications).