TML Multistate Intergovernmental Employee Benefits Pool d b a TML Health Benefits Pool

Role Description The Member Experience Escalation Advocate is a key member of the Member Experience team, responsible for resolving highly complex service escalation issues from TX HB members, Benefit Coordinators, Member Service Advocates, Marketing staff, and other internal TX HB stakeholders. Work involves investigating service issues and working with the third-party administrator (TPA) or other benefit service providers to resolve issues in a timely manner. Assists with staff training and mentoring as a subject matter expert related to TX HB benefits administration, including processes, rules, and regulations. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. This role requires a high level of expertise in de-escalating irate members and navigating stressful situations. This individual should have excellent communication skills both verbally and in writing. This individual has strong partnering and rapport building skills in order to work effectively with other departments and vendors. Qualifications - Expert knowledge of all TX HB administered benefits, including policies, processes, rules, and regulations. - Excellent verbal and written communicator, particularly with respect to diffusing irate situations. - Strong knowledge of eligibility requirements including Section 125 rules. - Proficient in MS Office including PowerPoint and Excel. - Strong time management, organization, and prioritization skills. - Ability to work effectively in a shifting environment. - Advanced problem solving and critical thinking skills, including the ability to identify trends in data. - Strong attention to detail and ability to prioritize and organize workload. - Advanced knowledge of contact center software and tools. - Ability to coach and mentor staff. Requirements - Associate’s degree. - Three or more years in a contact center environment including at least two years of experience in a health insurance/healthcare related contact center. - One or more years of experience handling escalated calls. Preferred - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is generally preferred. Experience and education may be substituted for one another. - Two years of experience working at TX HB. Work at Home Environment - Office location is in a quiet low traffic area to minimize noise and disruptions. - A private, enclosed space with a door is preferred to support member confidentiality and ensure compliance privacy standards. - Must reside in Texas. Physical Demands - Ability to speak/hear clearly to communicate by phone or in person. - Ability to frequently stand, sit and walk. - Ability to frequently lift and/or move up to 15 pounds. - Prolonged periods of sitting at a desk and working on a computer. Flexible Work Arrangements - 100% Remote (MON-FRI). Work Schedule - 8:00 AM - 5:00 PM (MON-FRI) - May be asked to work non-standard hours during peak times.

Role Description Performs moderately advanced benefits program administration and member assistance work. Work involves determining benefits eligibility, processing applications for benefits, and providing guidance to Benefit Coordinators with benefits eligibility inquiries. Works under moderate supervision, with some latitude for the use of initiative and independent judgment. The ideal candidate for this position will have a comprehensive understanding of employee benefits, strong problem-solving skills, excellent verbal and written communication skills, a commitment to customer service, enjoy interacting with people, and be comfortable working in a fast-paced and structured environment. Essential Duties and Responsibilities - Answers incoming inquiries (e.g. phone calls, emails, etc.) from Benefit and Billing Coordinators regarding benefit administration, eligibility, billing, and any other questions regarding employee benefits. - Contacts benefit coordinators to resolve potential issues that have been identified internally. - Clearly documents case activities, outcomes, and feedback received by members. - Proactively handles own caseload and shared work queues to ensure timely resolution of escalated issues while meeting service levels and quality standards. - Processes changes to employee and dependent TXHB offered benefits, demographics, and beneficiary information. - Builds effective working relationships with Benefit Coordinators and others at assigned groups. - Serves as a resource for Benefit Coordinators, guiding and mentoring them regarding TXHB benefit administration processes, policies, and procedures. - Conducts basic data reviews of cases and inquiries to identify recurring issues, knowledge gaps, or process breakdowns and recommends potential solutions to leadership. - Proactively identifies and reaches out to Benefit Coordinators to discuss ongoing benefits or eligibility trends related to individual group benefit administration challenges. - Collaborates with other internal teams and external vendors to resolve eligibility and billing questions or issues. - Provide direction to peers by assisting with trainings as directed by Supervisor. - Participates on cross‑functional project teams focused on implementing new clients, systems, or benefit programs by representing the advocate perspective and validating processes. - May review and provide feedback on AI-generated responses provided to group contacts. - May serve as a backup for cross‑departmental work, including supporting special projects, documenting and testing new or updated processes, assisting with trainings, and contributing to operational readiness activities during peak periods or program changes. Qualifications - Strong knowledge of eligibility requirements including Section 125 and COBRA rules. - Strong knowledge of MS Office and billing and enrollment software. - Strong problem-solving and research skills. - Ability to effectively communicate complex benefits administration subjects both verbally and in writing. - Effective time management, organization, and prioritization skills. - Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules. - Ability to work in a team environment and perform multi-task job functions. - Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed. - Ability to convey a professional manner in dealing with others and maintain constructive working relationships. - Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines. - Ability to effectively work within rapidly changing circumstances as needed. Requirements - 1-2 years of work experience in a related field such as Human Resources or health insurance. - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred. - Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred. Physical Demands - Ability to speak/hear clearly to communicate by phone or in person. - Ability to frequently stand, sit and walk. - Ability to frequently lift and/or move up to 15 pounds. - Prolonged periods of sitting at a desk and working on a computer. Flexible Work Arrangements - 100% Remote (MON-FRI) Work Schedule - 8:00 AM - 5:00 PM (MON-FRI)

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Performs moderately advanced benefits program administration and member assistance work. Work involves determining benefits eligibility, processing applications for benefits, and providing guidance to Benefit Coordinators with benefits eligibility inquiries. - Answers incoming inquiries (e.g. phone calls, emails, etc.) from Benefit and Billing Coordinators regarding benefit administration, eligibility, billing, and any other questions regarding employee benefits. - Contacts benefit coordinators to resolve potential issues that have been identified internally. - Clearly documents case activities, outcomes, and feedback received by members. - Proactively handles own caseload and shared work queues to ensure timely resolution of escalated issues while meeting service levels and quality standards. - Processes changes to employee and dependent TXHB offered benefits, demographics, and beneficiary information. - Builds effective working relationships with Benefit Coordinators and others at assigned groups. - Serves as a resource for Benefit Coordinators, guiding and mentoring them regarding TXHB benefit administration processes, policies, and procedures. - Conducts basic data reviews of cases and inquiries to identify recurring issues, knowledge gaps, or process breakdowns and recommends potential solutions to leadership. - Proactively identifies and reaches out to Benefit Coordinators to discuss ongoing benefits or eligibility trends related to individual group benefit administration challenges. - Collaborates with other internal teams and external vendors to resolve eligibility and billing questions or issues. - Provides direction to peers by assisting with trainings as directed by Supervisor. - Participates on cross‑functional project teams focused on implementing new clients, systems, or benefit programs by representing the advocate perspective and validating processes. - May review and provide feedback on AI-generated responses provided to group contacts. - May serve as a backup for cross‑departmental work, including supporting special projects, documenting and testing new or updated processes, assisting with trainings, and contributing to operational readiness activities during peak periods or program changes. Qualifications - 1-2 years of work experience in a related field such as Human Resources or health insurance - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred. - Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred. Requirements - Strong knowledge of eligibility requirements including Section 125 and COBRA rules. - Strong knowledge of MS Office and billing and enrollment software. - Strong problem-solving and research skills. - Ability to effectively communicate complex benefits administration subjects both verbally and in writing. - Effective time management, organization, and prioritization skills. - Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules. - Ability to work in a team environment and perform multi-task job functions. - Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed. - Ability to convey a professional manner in dealing with others and maintain constructive working relationships. - Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines. - Ability to effectively work within rapidly changing circumstances as needed. Physical Demands - Ability to speak/hear clearly to communicate by phone or in person. - Ability to frequently stand, sit and walk. - Ability to frequently lift and/or move up to 15 pounds. - Prolonged periods of sitting at a desk and working on a computer. Flexible Work Arrangements - 100% Remote (MON- FRI) Work Schedule - 8:00 AM - 5:00 PM (MON- FRI)

Role Description Performs moderately advanced benefits program administration and member assistance work. Work involves determining benefits eligibility, processing applications for benefits, and providing guidance to Benefit Coordinators with benefits eligibility inquiries. Works under moderate supervision, with some latitude for the use of initiative and independent judgment. The ideal candidate for this position will have a comprehensive understanding of employee benefits, strong problem-solving skills, excellent verbal and written communication skills, a commitment to customer service, enjoy interacting with people, and be comfortable working in a fast-paced and structured environment. Qualifications - Strong knowledge of eligibility requirements including Section 125 and COBRA rules. - Strong knowledge of MS Office and billing and enrollment software. - Strong problem-solving and research skills. - Ability to effectively communicate complex benefits administration subjects both verbally and in writing. - Effective time management, organization, and prioritization skills. - Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules. - Ability to work in a team environment and perform multi-task job functions. - Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed. - Ability to convey a professional manner in dealing with others and maintain constructive working relationships. - Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines. - Ability to effectively work within rapidly changing circumstances as needed. Requirements - 1-2 years of work experience in a related field such as Human Resources or health insurance. - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred. - Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred. Benefits - 100% Remote (MON-FRI) - Work Schedule: 8:00 AM - 5:00 PM (MON-FRI) Essential Duties and Responsibilities - Answers incoming inquiries (e.g. phone calls, emails, etc.) from Benefit and Billing Coordinators regarding benefit administration, eligibility, billing, and any other questions regarding employee benefits. - Contacts benefit coordinators to resolve potential issues that have been identified internally. - Clearly documents case activities, outcomes, and feedback received by members. - Proactively handles own caseload and shared work queues to ensure timely resolution of escalated issues while meeting service levels and quality standards. - Processes changes to employee and dependent TXHB offered benefits, demographics, and beneficiary information. - Builds effective working relationships with Benefit Coordinators and others at assigned groups. - Serves as a resource for Benefit Coordinators, guiding and mentoring them regarding TXHB benefit administration processes, policies, and procedures. - Conducts basic data reviews of cases and inquiries to identify recurring issues, knowledge gaps, or process breakdowns and recommends potential solutions to leadership. - Proactively identifies and reaches out to Benefit Coordinators to discuss ongoing benefits or eligibility trends related to individual group benefit administration challenges. - Collaborates with other internal teams and external vendors to resolve eligibility and billing questions or issues. - Provide direction to peers by assisting with trainings as directed by Supervisor. - Participates on cross-functional project teams focused on implementing new clients, systems, or benefit programs by representing the advocate perspective and validating processes. - May review and provide feedback on AI-generated responses provided to group contacts. - May serve as a backup for cross-departmental work, including supporting special projects, documenting and testing new or updated processes, assisting with trainings, and contributing to operational readiness activities during peak periods or program changes.