Description:
The Fully Remote 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 fully remote role that requires compliance to work only within the contiguous US.
Remote 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)
Job Duties/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.
Job Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Experience
- 2+ years of customer service, contact center, or member support experience, preferably in healthcare and/or Medicare Advantage.
Education
- High school diploma or GED required.
- College degree, Associate’s or Bachelor’s preferred or any equivalent combination of education and work experience