Customer Success Team Lead II

The Customer Success Team Lead II provides operational oversight and subject matter leadership for Tier 2 Customer Success Operations. This role supports complex case distribution, backlog health, SLA adherence, specialist coaching, quality review, case consultation, and cross-functional issue resolution.

About the Company

Antidote Health is a tech- driven health insurance company on a mission to make healthcare easy, accessible, and more affordable. We’re rethinking how healthcare works—using technology to remove the friction, complexity, and delays that define the traditional system. Instead of navigating paperwork, long waits, and disconnected experiences, we’re building a simpler, more connected way for people to get care.

Our platform combines health coverage, virtual care, and a modern member experience into one seamless system designed to help people actually use their benefits.

We offer Affordable Care Act (ACA) health plans in Arizona and Ohio, and we’re growing quickly. We’re building a company focused on solving real problems—with real impact on people’s lives.

Position Overview

Key Responsibilities

Manage daily Tier 2 work distribution, case queues, backlog aging, SLA risks, and priority escalations.
Serve as a senior subject matter expert for complex claims, billing, eligibility, enrollment, provider access, refund, and multi-touch cases.
Review case documentation, investigation quality, customer communications, and escalation readiness.
Coach Customer Success Specialist II team members on critical thinking, root cause analysis, documentation, and resolution strategy.
Partner with Tier 1 Team Leads to improve escalation quality and reduce preventable handoffs.
Partner with Tier 3 on escalated complaints that may create regulatory or executive risk.
Identify trends, process defects, training gaps, system issues, and recurring operational breakdowns.
Support SOP refinement, knowledge base updates, QA calibration, and training reinforcement.
Provide concise operational updates to the Manager, Customer Success Operations, including backlog risks and recommended mitigation.
Model ownership, analytical rigor, accuracy, and customer advocacy.

Qualifications

Required:

3 or more years of customer service, health plan, insurance, claims, billing eligibility, enrollment or customer operations experience.
2 or more years of senior specialist, lead, coaching, escalation, or operational coordination experience.
Strong expertise in complex case management and cross-functional issue resolution.
Ability to interpret operational data, identify risk, and prioritize work effectively.
Strong written communication and documentation review skills.
High school diploma or GED required.
Completion of leadership essentials, HIPAA, quality calibration, and performance coaching training required.

Preferred:

ACA marketplace or health plan operations experience.
Experience with Salesforce, claims systems, eligibility systems, payment systems, reporting tools, and WFM or QA platforms.
Experience managing backlog, inventory, SLAs, and process improvement initiatives.
Lean, Six Sigma, quality, or process improvement exposure.
Associates or Bachelors degree is preferred.

Competencies

Ownership and accountability: works issues to resolution rather than transferring responsibility unnecessarily.
Member and customer advocacy: seeks to understand the customer goal, the barrier, the accountable owner, and the fastest compliant path to resolution.
Clear communication: translates benefits, eligibility, deductibles, claims, referrals, prior authorization, premiums, and other healthcare concepts into plain language.
Critical thinking: identifies root causes, asks investigative questions, and recognizes when an issue does not align with expected process or system behavior.

Calm authority: communicates findings with accuracy, confidence, and professionalism while avoiding speculation.
Emotional intelligence and de-escalation: steadies difficult interactions and maintains professionalism under pressure.
System fluency: navigates CRM, claims, eligibility, benefits, provider lookup, payment, scheduling, knowledge base, and case management tools efficiently.
Compliance mindset: maintains HIPAA, privacy, CMS, ACA, state DOI, and internal policy requirements.

Documentation discipline: records clear, complete, and audit-ready notes that support continuity and accountability.
Adaptability and resilience: succeeds in a fast-paced, evolving health plan environment.

Training and Work Shift Expectations

Completion of required Antidote Health onboarding and role-based training.
Completion of HIPAA, privacy, security, compliance, systems, and workflow training.
Participation in quality coaching, calibration, refresher training, and ongoing competency checks as assigned.
For frontline and specialist roles, successful completion of nesting or readiness assessments before independent queue assignment may be required.
Shift flexibility is required based on staffing needs, contact volume, regulatory deadlines, customer demand, and Open Enrollment Period support.
Specific shift assignments are based on business needs and should be confirmed during the recruiting and offer process

Compensation and Benefits

Compensations range: $34.00-$43.00/Hour (commensurate with experience and location)

Comprehensive benefits package including medical, dental, vision

401(k)

Paid vacation and sick time and company holidays

Company Standards and Expectations

Employment is at-will, meaning either the employee or the company may terminate employment at any time, with or without cause, in accordance with applicable law

Employees are expected to adhere to all company policies, including confidentiality, data protection, and code of conduct

Responsibilities may evolve based on business needs, and flexibility is expected as the company scales

Compliance with all applicable federal, state, and local laws and regulations is required

Equal Opportunity Statement

Antidote Health is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.

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