XO Health Healthcare Support Advocate
About the job
XO Health believes healthcare is fixable. Become a part of the community changing the face of the industry. XO Health is the first health plan designed by and for self-insured employers that delivers a more unified health experience for everyone-from those who receive care, to those who deliver it, to those who pay for it. We are growing a multi-disciplinary team of diverse and digitally empowered employees ready to rebuild trust in healthcare through comprehensive and unified transformation.
About the Role:
Remote- USA -Virtual Contact Center
The Healthcare Support Advocate is a key member of XO Health’s operations team, supporting both member and provider servicesthrough our virtual contact center. This role serves as a primary point of contact for members and providers through an omni-channel environment (phone, email, chat).
This position requires a strong service-first mindset, high attention to detail, and the ability to move seamlessly between real-time support and behind-the-scenes operational work. The Healthcare Support Advocate partners cross-functionally with internal teams and third-party vendors to ensure members and providers receive timely, compliant, and high-quality support across the operations.
Key Responsibilities:
Member & Provider Advocacy
- 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 regarding benefits, eligibility, and coverage; claims status and adjudication details; prior authorization requirements and submissions; billing and reimbursement policy questions; and provider portal navigation and support.
- Resolve inquiries, complaints, grievances, and escalations promptly while ensuring 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.
Cross-Functional Collaboration & Continuous Improvement
- 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.
Performance & Compliance Expectations
- Meet performance goals in areas such as efficiency and productivity, quality and accuracy, customer satisfaction, compliance, follow-up completion, and attendance.
- Maintain confidentiality and compliance with HIPAA, ERISA, and XO Health policies.
Experience Required:
The qualified candidate must have:
- 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.
- Strong 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.
Preferred Skills:
- Associate or bachelor’s degree in healthcare administration, business, or a related field.
- Familiarity with Availity Essentials, payer portals, and EDI standards.
- Familiarity with Genesys, Service Now, and other CRM tools
- Familiarity with Facility, Physician, Ancillary, and Behavioral Health, claim types.
- Spanish language proficiency (written and verbal) is a plus.
Additional Details:
- Must be able to support contact center hours of 8:00am – 5:30pm ET.
- Must be able to participate in a rotating on-call schedule for urgent member and provider support needs.