Remote-Resolution Specialist

📋 Description

• • The Remote-Resolution Specialist at Alignment Healthcare is a frontline problem solver responsible for managing and resolving complex member issues related to authorizations, claims, benefits, provider access, and service experience, ensuring compassionate and timely resolution while upholding regulatory and organizational standards.
• • Day to day, the specialist owns assigned cases from intake through closure, conducts proactive outbound outreach and handles inbound contacts, provides clear explanations of health plan benefits and coverage, documents case details accurately, collaborates with internal and external teams to resolve multi-departmental concerns, and identifies trends to support continuous improvement in member experience.
• • Alignment Healthcare is a mission-driven organization dedicated to transforming care for seniors and the chronically ill, built on a team of passionate individuals committed to putting the senior first, offering a fast-growing environment with opportunities for innovation and meaningful impact.
• • In this role, the individual can develop deep expertise in healthcare navigation, case management, and cross-functional coordination, strengthen communication and problem-solving skills, contribute to process improvements, and grow within a supportive team that values mentorship, knowledge sharing, and professional development.