Alignment Health · 2 months ago
Customer Service Representative - Must live in Nevada
United States
Full-time
Remote
Entry Level
$42K/yr - $62K/yr
1+ years expAlignment Health is a company dedicated to transforming healthcare for seniors and those with chronic illnesses. The Regional Concierge Navigator will provide outreach and support to members, ensuring they have access to necessary healthcare and benefits while maintaining a high level of coordinated care.
Health CareHospitalMedicalMedical DeviceWellness
Responsibilities
Provides in-market, specialized member support in respective market or region
Conducts in-market member engagement including Welcome Calls, New Member Onboarding, JSA Scheduling, High Quality PCP and Provider Terms, Product/Vendor Changes, CAHPS Proxy, Disenrollment Quality Assurance, and Proactive Service Recovery
Conducts case follow-ups and quality member issue resolution for all cases assigned
Ensures members have access to PCP and specialists to coordinate care
Educates members on gaps in care and assists with scheduling provider appointments
Serves as the patient's liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures
Makes appropriate and timely patient appointments, reminders, and confirmations and Mails letters and correspondence as needed
Places regular/consistent outreaches to the patient
Communicates with PCP with any member updates and requests
Assists with obtaining medical records from any healthcare providers involved in care or hospitals
Helps members with any authorizations and referrals involved in their care plan
Resolves incoming calls concerning members’ eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member’s primary care physician and proactively engage member with their wellness plan options
Participates in on-site member engagement activities as needed, such as in-person member meetings, handling lobby calls at a retail or care center location, etc. (subject to change)
Other duties as assigned
Qualification
Required
Minimum 1 year of customer service experience
High School Diploma or GED
Knowledge of ICD-10 and CPT codes
Keyboard typing 40+ words per minute
Ability to help members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors
Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals
Ability to write routine reports and correspondence
Ability to speak effectively before groups of customers or employees of the organization
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
Ability to deal with problems involving a few concrete variables in standardized situations
Ability to perform mathematical calculations and calculate simple statistics correctly
Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment
Preferred
High-volume inbound customer service experience, particularly for health plan or Medicare 'Member Services' roles in health plan and supplemental benefits preferred
Telemarketing and/or member outreach experience preferred
Specialized experience in escalation or resolution units preferred
Bilingual English/Spanish or English/Vietnamese or English/Mandarin
Fluency in written and verbal Spanish, Korean, or Vietnamese, a plus
Company
Alignment Health
Alignment Health provides eldercare services.
501-1000 employees
H1B Sponsorship
Alignment Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (17)
2022 (13)
2021 (11)
2020 (6)
Funding
Current Stage
Public CompanyTotal Funding
$696.05MKey Investors
K2 HealthVenturesWarburg PincusGeneral Atlantic
2024-11-15Post Ipo Debt· $321.05M
2024-01-09Private Equity
2021-03-26IPO
Leadership Team
Dawn Maroney
President, Markets & CEO of Alignment Health Plan
John Kao
CEO and Founder
Recent News
Alignment Healthcare USA, LLC
2025-10-31
Company data provided by crunchbase