Remote-Customer Experience Specialist

Alignment Health•California Corporate Office, CA

58d•$41,600 - $57,600•Remote

About The Position

The Customer Experience Specialist delivers compassionate, seamless service to Alignment Health members, primarily older adults and individuals with disabilities. The role focuses on building caring connections, advocating for members, navigating complex systems, and resolving issues completely and correctly, ideally during the initial contact. Specialists handle member inquiries and sensitive situations with empathy, patience, professionalism, and clear follow-through. This is a remote role for candidates working within the contiguous United States. Candidates may not reside in California or New York. The role requires a distraction-free workspace, confidentiality and HIPAA compliance, sufficient internet bandwidth, and appropriate technology equipment. Employees must be available to work shifts that meet business needs and participate in ongoing coaching, feedback, and performance improvement.

Requirements

At least 2 years of customer service, contact center, or member support experience; relevant college coursework or an Associate or Bachelor’s degree may be considered in lieu of experience.
High school diploma or GED required.
Demonstrated ability to use technology and follow detailed workflow instructions.
Proficiency navigating multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM, and contact center solutions.
Ability to appear on camera for training, one-on-one, team, and group meetings.
A distraction-free workspace and ability to maintain strict confidentiality and comply with HIPAA regulations.
Sufficient internet bandwidth and access to connect to Alignment systems during scheduled shifts.
Ability to properly care for and maintain availability of technology equipment, including headsets and keyboard, to perform job responsibilities during scheduled shifts.
Clear, concise, warm verbal communication skills and ability to explain complex information simply and compassionately and document interactions accurately.
Empathy, patience, and respect when working with older adults and individuals with disabilities.
Minimum typing speed of 40 WPM.
Comfort working with ongoing coaching, feedback, and performance improvement to meet KPIs related to attendance, schedule adherence, and quality.
Ability to manage high call volumes while handling complex, emotionally sensitive interactions.
Flexibility to work shifts to meet business needs.
High school diploma or GED is required; college degree, Associate’s or Bachelor’s, is preferred. Three or more years of customer service experience may be considered in lieu of a degree.
No licensure is required.

Nice To Haves

Bilingual in Spanish, Vietnamese, Korean, Mandarin, or Cantonese.
Knowledge of Medicare Advantage, Medi-Cal, or managed care plans.
Strong problem-solving skills and a proactive, ownership-driven mindset.
Organized, self-motivated, and comfortable in a fast-paced environment.
College degree, Associate’s or Bachelor’s.

Responsibilities

Build caring connections with members through empathetic, patient, and respectful interactions.
Take ownership of member interactions from beginning to resolution, resolving inquiries on initial contact when possible and following through on additional steps.
Provide exceptional service that exceeds member expectations and supports trust, compassion, and first-call resolution.
Respond accurately and clearly to inquiries about benefits, eligibility, services, policies, and procedures.
Assist with provider network, claims and reimbursement, transportation, food, dental, and other benefit or support-service inquiries; identify solutions and next steps.
Answer incoming contacts within established service levels and handle complex or sensitive situations professionally.
Document member interactions, actions, and outcomes accurately and in real time.
Address complaints, grievances, and disenrollment concerns by identifying root causes, offering solutions, and escalating when appropriate.
Support outbound outreach and service programs intended to improve member engagement, education, and experience.
Represent Alignment Healthcare with integrity and positivity, demonstrating a service-oriented mindset and commitment to excellence.
Participate in coaching, feedback, and learning to strengthen service skills and member advocacy.