Member Experience Clerk

Alignment Health is breaking the mold in conventional health care by serving seniors and those who need it most: the chronically ill and frail. The company brings together a passionate and caring team united in its mission to put the senior first. As a fast‑growing organization, Alignment Health offers ample room for growth and innovation while providing meaningful work that changes and saves lives.

The Member Experience Support Clerk is responsible for providing daily clerical support to the Member Services Department, including the Transportation Unit, Member Outreach Unit, and Appeals and Grievances Team.

• Tracks incoming member correspondence in the department mail log & EZ Member database.
• Assigns an MS Representative for follow‑up, including Request for Assistance forms from the Sales/Marketing Dept.
• Tracks the Health Risk Assessment surveys in the EZ Member database and logs HRA vitamin coupons.
• Maintains the department’s miscellaneous filing in an organized fashion and creates files for new staff as needed.
• Maintains inventory of department supplies ( Stock, PCP Change Forms,  Holders, Birthday Cards, Transportation Postcard Reminders, etc.) and orders supplies as required.
• Maintains daily monthly department mailings, including birthday cards, anniversary cards, condolence cards, and miscellaneous mailings.
• Acknowledges and logs the receipt of all grievances, appeals and CTM (Complaint Tracking Module) and provides clerical support to the Appeals and Grievance Coordinator.
• Assembles, maintains and protects member A&G case files in an organized fashion.
• Faxes grievance response requests to appropriate parties to gather all relevant information from the provider regarding the grievance/appeal.
• Provides follow‑up calls to providers and/or IPA and members to ensure compliance with CMS timelines.
• Logs points of contact of providers, IPA and members.
• Performs other clerical duties as assigned by the Department Manager.

None.

Required:

Minimum 1 month of related experience and/or training, or an equivalent combination of education and experience. Preferred:
None.

Required:

High School Diploma or GED. Preferred:
None.

Required:

None. Preferred:
None.

• Knowledge of Medi‑Cal Commercial and Medicare Managed Care Plans.
• Bilingual (English/Spanish) required.
• Basic computer skills 30 WPM (Microsoft Outlook, Excel, Word).
• 10‑Key by touch.
• 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 constructive relationships with diverse members, management, employees and vendors.
• Mathematical skills: ability to perform mathematical calculations and calculate simple statistics correctly.
• Reasoning skills: ability to prioritize multiple tasks; advanced problem‑solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions and design, implement and manage appropriate resolution.

Required:

None. Preferred:
None.

The physical demands described here represent those required to successfully perform this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pay Range: $41,600.00 – $57,600.00. Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation.

Please beware of recruitment phishing scams. Alignment Health and its subsidiaries will never ask you for a credit card, send you a check or request any payment as part of consideration for employment. If you believe you have been a victim of a scam, please report the incident to the Federal Trade Commission. To verify the legitimacy of an email from Alignment Health talent acquisition, please email the official contact listed on the company website.