Remote Bilingual Spanish Customer Experience Specialist

Alignment Health; United States; Remote; USD 42,000 - 58,000; Full time

Job summary

Alignment Health is seeking a Customer Experience Specialist to deliver compassionate, seamless service to our senior members. This remote role requires HIPAA compliance and resolving issues correctly the first time, while building caring connections across the member experience.

You will handle inquiries about benefits, eligibility, services and policies, document interactions in real time, and support outreach to improve engagement.

Qualifications

• Bilingual in Spanish (read, speak, write).
• 2+ years customer service or contact center experience, preferably in healthcare/Medicare Advantage.
• Proficient with Microsoft Outlook, Word, Excel, CRM and contact center tools.

Responsibilities

• Build caring connections with members with empathy, patience and respect.
• Own each member interaction end-to-end and resolve inquiries on first contact.
• Deliver exceptional service and aim for first-call resolution.
• Respond to inquiries about benefits, eligibility, services and policies clearly and confidently.
• Assist with provider network and claim/reimbursement inquiries and related questions.
• Answer incoming contacts within service levels and manage complex situations professionally.
• Document all interactions in real time for accuracy and continuity of care.
• Address complaints, grievances and disenrollment concerns with problem-solving and escalation when needed.
• Support outbound outreach initiatives to improve engagement and education.
• Represent Alignment Health with integrity and a serving-heart mindset.
• Participate in coaching and feedback to strengthen service skills.

Skills

Spanish bilingual

Customer service

HIPAA compliance

Education

High school diploma or GED

College degree preferred

Tools

Microsoft Outlook

Excel

CRM

Job description

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.

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.

Hourly rate: $20

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.

Required-Spanish Bilingual (Read, Speak, Write)

Experience

• 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.
• 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.
• Minimum typing speed of 35 WPM.
• 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.

Education

• 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.

Training

• Required: Demonstrated ability to use technology and follow detailed workflow instructions.

Strongly Preferred

• Knowledge of Medicare Advantage, Medi-Cal, or managed care plans preferred.

Essential Physical Functions

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $41,600.00 - $57,600.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

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.