Insurance Advocacy Specialist

About the Role

The Insurance Advocacy Specialist supports Take Command Health members by helping them navigate their ICHRA/QSEHRA benefits and health insurance coverage. This role owns member-facing advocacy cases end to end - answering coverage questions, resolving claims and enrollment issues, and helping members understand how to use their benefits. Over time, this role will cross-train into Care Tier 2 (T2), expanding scope across the Advocacy function.

This is a great fit for someone who has hands-on health insurance knowledge, enjoys solving problems for people, and can work independently once trained.

What You'll Do

Serve as the primary point of contact for member insurance advocacy cases (coverage clarification, enrollment troubleshooting, provider invoice inquiries)

Research and resolve complex insurance questions using our platforms, interacting cross-functionally, and internal documentation

Document case notes and outcomes clearly and consistently in HubSpot / CRM

Identify when a case needs escalation vs. when it can be resolved independently, and know how to make that call

Adhere to SOPs to prioritize work, follow escalation protocols, and ensure timely follow-up and follow-through to solution

Communicate with members in a way that's clear, empathetic, and sets accurate expectations

Spot patterns across cases and flag recurring issues or process gaps to the team lead

Once ramped, take on Care T2 responsibilities as part of cross-training

What You'll Need

1-3+ years of experience in health insurance (carrier, broker, benefits administration, or a related role) - candidates should understand core concepts like deductibles, EOBs, claims processes, and plan types

Customer service experience, ideally in a case-based or ticketing environment

Active health insurance license, or ability to obtain licensure within 90 days of hire (multiple state licenses preferred)

Strong analytical skills - comfortable digging into a problem, comparing information across sources, and reasoning through ambiguous situations

Self-starter who can work independently after onboarding, without needing step-by-step direction

Clear written and verbal communication

Comfortable working in HubSpot, Intercom, or similar CRM/ticketing tools (or able to learn quickly)

Adaptable - this is a fast-evolving industry and role scope will shift as the team grows

Nice to Have

Experience with ICHRA/QSEHRA or individual market health insurance specifically

Sound judgment on what's needed to close a case, even when the path isn't fully defined - many issues branch in unexpected ways and require re-assessing what resolution actually looks like

Experience working in a startup or fast-changing operational environment