Remote Member Experience Specialist

Alignment Health; Las Vegas (NV); Remote; USD 36,000 - 54,000; Full time

Job summary

Alignment Health is seeking a Customer Experience Specialist to deliver compassionate, seamless service to our members, primarily older adults and individuals with disabilities. You will listen deeply, advocate for the member, and resolve issues completely on first contact while navigating complex systems.

This remote role plans to transition to an on-site Las Vegas location; candidates must reside in the Las Vegas metro.

Qualifications

• 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.

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.

Skills

Customer service

Outlook

Excel

HIPAA

Typing 35 WPM

Bilingual

Education

High school diploma or GED

Associate/Bachelor’s degree preferred

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

CRM systems

Job description

Alignment Health is seeking a Customer Experience Specialist to deliver compassionate, seamless service to our members, primarily older adults and individuals with disabilities. You will listen deeply, advocate for the member, and resolve issues completely on first contact while navigating complex systems.

This remote role plans to transition to an on-site Las Vegas location; candidates must reside in the Las Vegas metro.