Intermediate / Senior Customer Experience Advocate

About Texicare

Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas.

Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare’s vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people’s lives.

We’re looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas.

Position Summary

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.

Essential Job Functions

In this role, you will :

• 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.
• Regularly work a schedule of 8:00 a.m. to 5:00 p.m. Central time, Mondays through Fridays.

Additional Senior-Level Responsibilities

• 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.

To be successful in this role, you must have:

• 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.
• A quiet, dedicated work space, free from distraction to best serve stakeholders.

It would be great if you:

• Are bilingual in English and Spanish.
• Have previous experience in a HIPAA-regulated environment.

Benefits

• Automatic 4% employer contribution to retirement plan
• 401k plan with 100% match up to 6%
• Flexible time off for vacation, illness, etc.
• Nine paid holidays
• Day one health, Rx, vision, and dental insurance
• Life and disability insurance
• Flexible spending account
• Pet coverage and pet Rx discounts
• Free identity theft protection
• Free 2nd medical opinion service

Location

This is a remote position. All employees must reside in Texas. Occasional travel to Austin for companywide meetings may be required.

Texicare is an equal opportunity employer.