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 & NewYork). Responsibilities 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. Qualifications 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. Physical Functions 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. Compensation Hourly Rate: $20/$21 (California & NewYork). Annual Pay Range: $41,600.00 – $57,600.00, based on location, experience, and responsibilities. Equal Opportunity Employer (EEO) Statement 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. #J-18808-Ljbffr E2E Alignment Healthcare USA, LLC