Job Overview
Location
Remote Arizona
Job Type
Full-time
Category
Marketing
Date Posted
June 23, 2026
Full Job Description
đź“‹ Description
- • Provide in-market, specialized member support to seniors and chronically ill members within a designated region, ensuring access to coordinated healthcare services.
- • Conduct Welcome Calls, New Member Onboarding, JSA Scheduling, and proactive service recovery to enhance member experience and retention.
- • Serve as the primary liaison between members and their healthcare providers, coordinating access to primary care physicians (PCPs) and specialists.
- • Educate members on gaps in care and assist with scheduling provider appointments, including follow-ups and reminders.
- • Resolve incoming member inquiries regarding eligibility, benefits, provider information, clinical needs, and pharmacy questions.
- • Assist members with obtaining medical records from healthcare providers and hospitals to support continuity of care.
- • Facilitate authorizations and referrals required under Medicare Advantage or HMO plans, ensuring compliance with plan guidelines.
- • Maintain accurate documentation and communicate member updates to PCPs and internal teams in a timely manner.
- • Perform regular outbound outreach to members to promote wellness plan options and address unmet healthcare needs.
- • Coordinate membership changes, including updates to primary care physicians and supplemental vendor enrollments.
- • Participate in on-site member engagement activities such as in-person meetings or retail center lobby support when required.
- • Navigate complex healthcare systems to help members understand and access their benefits, including Medicare Advantage, supplemental plans, and provider networks.
- • Apply knowledge of ICD-10 and CPT codes to accurately interpret and address member healthcare documentation and service needs.
- • Maintain a high volume of daily member interactions while adhering to company standard operating procedures and quality assurance standards.
- • Communicate clearly and professionally with diverse members, providers, vendors, and internal teams using effective oral and written communication skills.
- • Utilize computer systems to manage member cases, schedule appointments, send correspondence, and track service outcomes.
- • Demonstrate strong problem-solving, organizational, and time management skills in a fast-paced, remote work environment.
- • Perform all duties in compliance with privacy regulations and company policies while upholding a member-first approach.
🎯 Requirements
- • Minimum 1 year of customer service experience
- • High School Diploma or GED
- • Knowledge of ICD-10 and CPT codes
- • Keyboard typing speed of 40+ words per minute
- • Ability to navigate Medicare Advantage or HMO plans, including referrals and authorizations
- • Bilingual in English and Spanish (required)
🏖️ Benefits
- • Pay range of $44,790.00 - $67,185.00 based on market, experience, and responsibilities
- • 100% remote work environment
- • Opportunity for growth and innovation within a fast-growing healthcare organization
- • Work that directly impacts the lives of seniors and chronically ill members
Skills & Technologies
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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.
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