Member Experience Support Clerk

Alignment Health is breaking the mold in conventional health care committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we this fast-growing company you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters not only changing lives but saving them. Together.

Job Duties/Responsibilities:

• Tracks incoming member correspondence in the department mail log & EZ Member database.
• Assigns a MS Representative as appropriate for follow up including Request for Assistance forms from the Sales/Marketing Dept daily.
• Tracks the incoming Health Risk Assessment Surveys into the EZ Member database and logs all HRA Vitamin Coupons.
• Maintains the departments miscellaneous filing in an organized fashion and create files for new staff as needed.
• Maintains the inventory of department supplies (ID Card Stock PCP Change Forms ID Card Holders Birthday Cards Transportation Postcard Reminders etc.) and orders supplies as needed.
• Maintains daily monthly department mailings including but not limited to birthday cards anniversary cards condolence cards and miscellaneous mailings.
• Acknowledges and logs the receipt of all grievances appeals and CTM (Complaint Tracking Module). Provides clerical support to the Appeals and Grievance Coordinator.
• Assembles maintains & protects member A&G case files in an organized fashion.
• Faxes grievance response requests to appropriate parties for the gathering of all pertinent and relevant information from the provider regarding the grievance/appeal.
• Provides follow up calls to providers and/or IPA and members as appropriate to ensure compliance with timelines set forth to ensure CMS compliance.
• Logs point of contacts of providers and/or IPA and members.
• Performs other duties clerical or otherwise as assigned by the Department Manager.

Supervisory Requirements:

None.

Job Requirements:

Experience:

Required: Minimum 1 month of related experience and/or training; or equivalent combination of education and experience.

Preferred: None.

Education:

Required: High School Diploma or GED.

Preferred: None.

Training:

Required: None.

Preferred: None.

Specialized Skills:

Required:

• 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 a constructive relationship 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.

Licensure:

Required: None.

Preferred: None.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job the employee is regularly required to talk or hear. The employee regularly is required to stand walk sit use hand to finger handle or feel objects tools or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

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.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal be advised that Alignment Health and its subsidiaries will never ask you for a credit card send you a check or ask you for any type of payment as part of consideration for employment with our you feel that you have been the victim of a scam such as this please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team please email.