This is a full-remote position!
Alignment Healthcare is a population health management company dedicated to changing the way health care is delivered in the United States.
- Seeks and understands the needs and expectation of internal and external customers in a friendly, positive and outgoing manner.
- Explains the plan’s procedures, protocols, benefits, services, and any other necessary information to the members who telephone or visit the Member Services Department.
- Goes above and beyond to address all of the member’s inquiries and needs, focusing on first call resolution.
- Ensures timely and adequate follow up to ensure member is satisfied with the outcome and resolution of open or pending items until completely resolved.
- Facilitate member requests for changes with network provider changes, transportation requests, appointment scheduling, or any other member request for assistance as appropriate.
- Answer all incoming member phone calls within the department’s goal timeframe.
- Documents every incoming call during the course of the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.,) to ensure quality.
- Make all attempts to resolve all member disenrollment/cancellation requests, complaint/grievances, escalating access to care issues to Network and UM to facilitate the member’s access to care issue.
- Assist with Member Outreach programs and implementations as needed.
- Foster good corporate relations by practicing good customer service principles (i.e., positive attitude, helpful, etc.).
- Perform other duties as assigned by Department Management.
- Education and/or Experience: High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
- Certificates, Licenses, Registrations: None required.
- Computer literate, typing 40+ words per minute.
- Excellent communication skills, oral and written.