XO Health

XO Health: The first health plan for self-insured employers, creating a unified health experience for all stakeholders.

Insurance

Financials

1-10 (10)

Founded 2021

3 open positions

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Healthcare Support Advocate

1 hour, 16 minutes ago

United States

Full-time

Mid Level

Customer Support

Customer and Technical Support

CRM HIPAA

Apply Now

XO Health

XO Health: The first health plan for self-insured employers, creating a unified health experience for all stakeholders.

Insurance

1-10

Founded 2021

View All Jobs 3

Description

Handle inbound and outbound member and provider inquiries by phone, email, and chat with professionalism and empathy.
Initiate outreach to members to provide benefits information and assistance.
Explain benefits, eligibility, coverage, claims status, adjudication details, prior authorization requirements, billing, reimbursement, and provider portal support.
Resolve inquiries, complaints, grievances, and escalations while documenting cases accurately and routing issues when needed.
Conduct follow-up outreach to support resolution, satisfaction, and continuity of care or claim outcomes.
Collaborate with Claims Operations, Network Operations, and Account Management to resolve complex cases and improve service delivery.
Identify recurring issues, system gaps, and process inefficiencies and share feedback with leadership.
Meet performance goals for efficiency, productivity, quality, accuracy, customer satisfaction, compliance, follow-up completion, and attendance.
Maintain confidentiality and comply with HIPAA, ERISA, and company policies.

Requirements

3–5 years of experience in a healthcare payer, TPA, or health insurance environment with contact center or member/provider support experience.
Strong knowledge of health insurance concepts, benefits and eligibility, medical terminology, and claims lifecycle management.
Strong verbal and written English 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.
Associate or bachelor’s degree in healthcare administration, business, or a related field (preferred).
Familiarity with Availity Essentials, payer portals, and EDI standards (preferred).
Familiarity with Genesys, ServiceNow, and other CRM tools (preferred).
Familiarity with facility, physician, ancillary, and behavioral health claim types (preferred).
Spanish language proficiency, written and verbal, is a plus.
Ability to support contact center hours of 8:00am–5:30pm ET.
Ability to participate in a rotating on-call schedule for urgent support needs.

Benefits

Remote USA virtual contact center role.
Full compensation range of $55,000–$75,000 USD.
Compensation may vary based on candidate experience and relevant certifications.
Equal opportunity employer committed to diversity and inclusion.
Drug-free workplace.

Interested in this position?

Apply directly on the company website

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