Remote Customer Experience Specialist

Overview

Fully Remote Customer Experience Specialist – delivering compassionate, seamless service to valued members including older adults and individuals with disabilities. Role requires remote work exclusively within the contiguous United States. Hourly Rate: $20/$21 (California & New York).

• Build caring connections with each member, leading with empathy, patience, and respect.
• Own every interaction end‑to‑end, resolving inquiries on the first contact and ensuring clear follow‑through when additional steps are needed.
• Consistently exceed member expectations, reinforcing a culture of trust, compassion, and first‑call resolution.
• Accurately address member inquiries regarding benefits, eligibility, services, policies, and procedures in a clear, confident, member‑friendly manner.
• Assist members with provider network and claim/reimbursement inquiries, benefit questions related to transportation, food, dental, and other support services, proactively identifying solutions and next steps.
• Answer incoming contacts within established service levels while managing complex and sensitive situations with professionalism and care.
• 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, 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 Health 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 continually strengthen service skills and member advocacy.

• 2+ years of customer service, contact center, or member support experience, preferably in healthcare or Medicare Advantage.
• High school diploma or GED required; college degree or equivalent preferred.
• Demonstrated ability to use technology and follow detailed workflow instructions.
• Minimum typing speed of 40 WPM.
• Proficiency in navigating multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM, and contact‑center solutions.
• On‑camera presence required for remote training, one‑on‑one, team, and group meetings.
• Workspace free of distractions with strict confidentiality and HIPAA compliance.
• Sufficient internet bandwidth and equipment (headset, keyboard) to connect with Alignment’s systems during scheduled shifts.
• Clear, concise, warm verbal communication skills and ability to explain complex information simply.
• Accurate documentation of interactions.
• Empathy, patience, and respect when working with older adults and individuals with disabilities.
• Comfortable with 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.
• Preferred:
  Bilingual Spanish (read, write, speak).
• Knowledge of Medicare Advantage, Medi‑Cal, or managed care plans advantageous.
• Strong problem‑solving skills with a proactive, ownership‑driven mindset.
• Organized, self‑motivated, and comfortable working in a fast‑paced environment.

Employees will regularly talk or hear, stand, walk, sit, use hands, handle tools or controls, and reach with hands and arms. Frequently lifts and/or moves up to 10 pounds. Requires close vision and the ability to adjust focus. Reasonable accommodations available to enable individuals with disabilities to perform essential functions.

Hourly Rate: $20/$21 (California & New York). Annual Pay Range: $41,600.00 – $57,600.00, based on location, experience, and responsibilities.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.