Remote Member Experience Specialist

E2E Alignment Healthcare USA, LLC; United States; 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. This remote role requires residing in Las Vegas, NV for consideration and emphasizes empathy, accountability, and first-call resolution.

Responsibilities include handling inquiries about benefits and policies, guiding provider network and claims questions, and documenting interactions precisely while maintaining HIPAA

Qualifications

• HS diploma or GED required; college coursework may be considered.
• 2+ years in customer service, contact center, or member support, preferably in healthcare.
• Ability to navigate multiple systems and maintain HIPAA compliance.

Responsibilities

• Build caring connections with every member by empathy, patience, and respect.
• Own each member interaction end-to-end; resolve inquiries during the initial contact.
• Deliver exceptional service by consistently exceeding member expectations and focusing on first-call resolution.
• Respond to member inquiries regarding benefits, eligibility, services, policies, and procedures clearly.
• Assist members with provider network and claim/reimbursement inquiries and related services.
• Document all member interactions in real time to ensure accuracy and continuity of care.
• Address member complaints and disenrollment concerns to resolve root causes with appropriate escalation.

Skills

Empathy

Active listening

Effective communication

Multitasking

HIPAA compliance

Bilingual

Education

High school diploma or GED

Associate's or Bachelor's preferred

Tools

CRM

Microsoft Outlook

Microsoft Word

Microsoft Excel

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. This remote role requires residing in Las Vegas, NV for consideration and emphasizes empathy, accountability, and first-call resolution.

Responsibilities include handling inquiries about benefits and policies, guiding provider network and claims questions, and documenting interactions precisely while maintaining HIPAA