Healthcare Support Advocate

XO Health believes healthcare is fixable. Become 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.

XO Health Healthcare Support Advocate

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 services through 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.

XO Health is an equal opportunity employer committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age, national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, citizenship, immigration status, protected veteran status, or any other basis prohibited under applicable federal, state or local law. XO Health promotes a drug-free workplace.