Job Overview
Location
Anywhere in the U.S.
Job Type
Full-time
Category
Operations
Date Posted
May 20, 2026
Full Job Description
đź“‹ Description
- • The Bilingual Spanish Resolution Specialist plays a critical role in resolving complex member issues related to healthcare insurance claims, ensuring timely and accurate resolutions that directly impact member satisfaction and care access.
- • Day-to-day responsibilities include handling escalated member calls regarding authorizations, claims, and provider network issues; conducting outbound and inbound calls aligned with member communication preferences; documenting interactions with precision; identifying process improvements; collaborating with internal and external partners; and supporting training initiatives for new hires.
- • Alignment Healthcare, LLC is a mission-driven organization dedicated to transforming healthcare for seniors and the chronically ill, fostering a culture of innovation, compassion, and operational excellence where employees contribute to meaningful, life-impacting work.
- • In this role, the individual will develop deep expertise in Medicare Advantage plans, healthcare navigation, and member advocacy; strengthen analytical and communication skills; gain experience in process improvement and VoC initiatives; and grow into a trusted subject matter expert within the member engagement team.
🎯 Requirements
- • Minimum 1 year of healthcare experience (with 3–4 years preferred) and experience helping members navigate Medicare Advantage benefits, including medical, prescription drug, and supplemental services.
- • Minimum 1 year of outbound or inbound call center experience, preferably in healthcare-related programs involving escalation, resolution, or problem-solving.
- • Bilingual proficiency in English and Spanish (or Mandarin/Cantonese/Vietnamese) with intermediate skills in Microsoft Office Suite (Outlook, Word, Excel).
- • High school diploma or GED; ability to troubleshoot, problem-solve, interpret documents, write routine reports, and communicate effectively with members and internal teams.
- • Availability to work full-time Monday–Friday across multiple time zones (PT, MT, CT, ET) and mandatory availability during Annual Enrollment (Oct–Dec) and Open Enrollment (Jan–Mar) periods, with no time off allowed during the first 5 weeks of training or the entire month of January.
🏖️ Benefits
- • Opportunity to work remotely from anywhere in the U.S. with a structured schedule aligned to regional time zones.
- • Competitive pay range of $41,600.00 to $57,600.00 annually, based on experience, location, and responsibilities.
- • Comprehensive training and ongoing development, including shadowing and mentoring opportunities for career growth.
- • Meaningful work impacting senior health outcomes, with a mission-driven culture focused on putting members first.
- • Equal Opportunity Employer commitment to diversity, inclusion, and fair hiring practices regardless of background or identity.
Skills & Technologies
About Alignment Healthcare, LLC
Alignment Healthcare is a health insurance company that focuses on providing personalized care for seniors and underserved populations. They operate a value-based care model, aiming to improve health outcomes and reduce costs through integrated care teams, technology, and data analytics. Their services include Medicare Advantage plans, chronic care management, and home-based care. Alignment Healthcare partners with providers and aims to deliver a seamless and high-quality healthcare experience for its members, emphasizing proactive and preventive care to keep individuals healthy and out of the hospital.
Subscribe to the weekly newsletter for similar remote roles and curated hiring updates.
Newsletter
Weekly remote jobs and featured talent.
No spam. Only curated remote roles and product updates. You can unsubscribe anytime.
Similar Opportunities
Strategic Growth Partners, LLC
3 months ago
GE HealthCare Technologies Inc.
2 months ago
