Customer Experience Specialist

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

• Foster meaningful connections with members through compassionate, patient, and respectful communication.

• Take ownership of member interactions from start to finish and resolve inquiries on the first contact whenever possible.

• Provide outstanding service while promoting trust, empathy, and first-call resolution.

• Address questions regarding benefits, eligibility, services, policies, and procedures.

• Assist with inquiries related to provider networks, claims/reimbursement, transportation, food, dental, and other support services.

• Respond to incoming queries within established service levels.

• Record member interactions, actions taken, and outcomes in real time.

• Handle complaints, grievances, and disenrollment issues; identify underlying causes, propose solutions, and escalate when necessary.

• Support outbound outreach initiatives and service programs.

• Represent Alignment Healthcare with integrity, positivity, and a service-oriented mindset.

• Engage in continuous coaching, feedback, and learning opportunities.

⛳️ Requirements

• A minimum of 2 years of experience in customer service, contact center, or member support, ideally in healthcare and/or Medicare Advantage.

• High school diploma or GED is mandatory.

• Relevant college coursework or an Associate/Bachelor’s degree may be accepted in place of experience.

• Proven ability to utilize technology and adhere to detailed workflow instructions.

• Proficient in using Microsoft Outlook, Word, Excel, CRM, and Contact Center solutions.

• Comfortable appearing on camera for training sessions and meetings.

• Maintain a distraction-free workspace and uphold strict confidentiality and HIPAA compliance.

• Adequate internet bandwidth and access to Alignment’s systems during scheduled shifts are required.

• Properly maintain and ensure availability of technology equipment, including a headset and keyboard.

• Exhibit clear, concise, and friendly verbal communication along with accurate documentation skills.

• Show empathy, patience, and respect when interacting with older adults and individuals with disabilities.

• Minimum typing speed of 40 WPM is essential.

• Capability to meet KPIs related to attendance, schedule adherence, and quality standards.

• Ability to manage high call volumes and handle complex, emotionally sensitive interactions.

• Willingness to work shifts to accommodate business needs.

• 3+ years of customer service experience may be considered in lieu of a degree.

• Bilingual proficiency in Spanish, Vietnamese, Korean, Mandarin, or Cantonese is highly preferred.

• Familiarity with Medicare Advantage, Medi-Cal, or managed care plans is preferred.

🏝️ Benefits

• Comprehensive health benefits package.

• Opportunities for professional development and training.

• Supportive work environment that values team collaboration.

• Flexible work schedules to promote work-life balance.