About The Position

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Customer Experience Specialist plays a critical role in delivering compassionate, seamless service to our valued members — primarily older adults and individuals with disabilities. This role goes beyond answering questions; it is about building caring connections, owning the member experience, and always resolving issues completely and correctly the first time. This is a remote role that requires compliance to work only within the contiguous US. Customer Experience Specialists take personal responsibility for each interaction — listening deeply, advocating for the member, navigating complex systems, and following through until resolution is achieved. Every contact is an opportunity to make health care easier, clearer, and more supportive for our members. Hourly Rate: $20 / $21 (CA & NY)

Requirements

  • 2+ years of customer service, contact center, or member support experience, preferably in healthcare and/or Medicare Advantage. Relevant college coursework or an Associate/Bachelor’s degree may be considered in lieu of experience.
  • High school diploma or GED required. College degree, Associate’s or Bachelor’s preferred. 3+ years of customer service work experience considered in lieu of degree.
  • Demonstrated ability to use technology and follow detailed workflow instructions.
  • Bilingual Spanish (Read, Write, Speak)
  • Minimum typing speed of 40 WPM.
  • Proficient in navigating multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM and Contact Center solutions.
  • On camera presence for training, one on one, team and group meetings.
  • Workspace must be free of distractions with the ability to maintain strict confidentiality and compliance with HIPAA regulations.
  • Sufficient internet bandwidth and access to connect with Alignment’s systems during scheduled shift.
  • Proper care and availability of technology equipment such as headsets, keyboard, to perform responsibilities without impact on operational and scheduled shift requirements.
  • Clear, concise and warm verbal communication skills with the ability to explain complex information simply and compassionately and ability to document interactions accurately
  • Demonstrated empathy, patience, and respect when working with older adults and individuals with disabilities.
  • Comfortable working in a culture of continuous coaching, feedback, and performance improvement to meet defined 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.

Nice To Haves

  • Knowledge of Medicare Advantage, Medi-Cal, or managed care plans preferred.
  • Strong problem-solving skills with a proactive, ownership-driven mindset.
  • Organized, self-motivated, and comfortable working in a fast-paced environment.

Responsibilities

  • Build caring connections with every member by always leading with empathy, patience, and respect, ensuring members feel heard, supported, and valued throughout every interaction.
  • Own each member interaction end-to-end, taking accountability to resolve inquiries during the initial contact and ensuring clear follow-through when additional steps are required.
  • Deliver exceptional service by consistently exceeding member expectations and reinforcing a culture focused on trust, compassion, and first-call resolution.
  • Accurately respond to member inquiries regarding benefits, eligibility, services, policies, and procedures in a clear, confident, and member-friendly manner.
  • Assist members with provider network and claim/reimbursement inquiries, benefit questions related to transportation, food, dental and other support services and needs, proactively identifying solutions and next steps.
  • Answer incoming contacts within established service levels while always managing complex and sensitive situations with professionalism and care.
  • Thoroughly document all member interactions, actions taken, and outcomes in real time to ensure accuracy, continuity of care and effective resolution.
  • Proactively address member complaints, grievances, and disenrollment concerns with goal to resolve by listening for root causes, offering solutions, and escalating appropriately when needed.
  • Support outbound outreach initiatives and service programs designed to improve engagement, education, and overall member experience.
  • Represent Alignment Healthcare with integrity and positivity, modeling a serving-heart mindset and commitment to excellence in every interaction.
  • Participate actively in ongoing coaching, feedback, and learning to continuously strengthen service skills and member advocacy.
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