Western Growers vacancy in Irvine, CA – CCSB – Customer Service Representative

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About the job

Join our team of dedicated professionals who are committed to ensuring our clients can provide affordable health benefit solutions for their employees.

Pinnacle Claims Management is a 3rd party administrator that provides health benefits administration and related services to companies that self-fund their insurance. We are also a contracted partner with CCSB.

Pinnacle is independently owned and has been serving clients for 20+ years. We are also part of the Western Growers Family of Companies.

Job Description Summary

Position reports directly to the Supervisor, Covered California for Small Business/Agent Call Center. This position provides consultative telephonic and web-based assistance to Agents, Certified Enrollment Counselors, Qualified Health Plans, federal and state agencies and other stakeholders in Health Benefit Exchange administration. Provide Customer Service support to clients by instructing them on correct eligibility management procedures and troubleshoot application issues and concerns.

Qualifications

• High school education or equivalent and/or two years’ experience within a call center or customer service environment. Experience in the healthcare industry especially with a health benefits company or a federal, state benefit program a plus.
• Knowledge of Health Benefits Exchange (HBEX), eligibility requirements and the application and enrollment processes preferred.
• Demonstrated skills in time management and team building.
• Ability to research and resolve technical issues and/or client problems as they arise with minimal direction.
• Knowledge of government regulations, federal, state and local health benefit programs preferred.
• Ability to retain and apply knowledge of the various operations of the organization, products and services.
• Strong verbal communication skills including active listening; uses written communication skills to record inquiry information and activity into the Client Relationship Management (CRM) system.
• Must have moderate computing and keyboarding skills.
• Must have knowledge of CRM software.
• Bilingual in Spanish, Chinese, Korean or Vietnamese is a plus.

Duties And Responsibilities

Phone Support

• Provide telephonic and web-based outreach to provide informational support to assist with all aspects of the application process within the Covered California systems from sign up to termination.
• Must adhere to the call center Quality Guidelines to ensure the best phone support to our callers.

Customer Advocate

• Ability to foster and build working relationships with Agents, Certified Enrollment Counselors, federal and state agency contacts
• Must become the subject matter expert for Covered California, State Provided Programs and HealthCare.Gov.
• Serve as a representative of the Agent by displaying professionalism, knowledge and discretion in all interactions with other members of the Agent’s community and their customers.

Call Center Support

• Must meet all department service metrics for Attendance, Performance and Call Quality.
• Must be a key contributor to meeting our contractual obligations to Covered California.
• Be accountable, create a positive impact, and be diligent in delivering results.

Other

• Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results.
• All other duties as assigned.

PHYSICAL DEMANDS/WORK ENVIRONMENT

The physical demands and work environment described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate.

Company: Western Growers

Vacancy Type: Full-time · Associate 

Job Location: Irvine, CA

Application Deadline: N/A

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