Customer Experience Specialist

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.

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.

*Candidates must reside in Las Vegas, NV for consideration.

Hourly Rate: $20

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.

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.

Specialized Skills:

• Required:

• 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 40 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.

• Strongly Preferred:

• Bilingual (Spanish, Vietnamese, Korean, Mandarin, or Cantonese) strongly preferred.

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

• Strong problem-solving skills with a proactive, ownership-driven mindset.

• Organized, self-motivated, and comfortable working in a fast-paced environment.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential 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.