Bilingual Client Services Specialist - Benefits & Enrollment

Western Growers Health; Fresno (CA); On-site; USD 45,000 - 65,000; Full time

Job summary

Western Growers Health is seeking a Client Service Representative I to manage enrollment, implementation and education of WGAT and PCMI health plans. You will collaborate with vendors and support plan participants at group sites via phone or virtual platforms.

You will conduct bilingual group presentations in English and Spanish, assist with enrollment paperwork, answer benefits questions, and generate reports to improve service delivery.

Responsibilities

• Educate newly enrolled and existing plan participants on health plan and ancillary benefits at group’s work site locations, via phone or virtual platforms.
• Conduct group benefits presentations in both English and Spanish for WGAT and PCMI plan participants.
• Interface with third party vendors/providers to communicate and educate them on benefits and programs specific to WGAT plan participants.
• Provide one-on-one support to address applicant concerns or questions.
• Serve as the primary contact for questions regarding benefits utilization.
• Assist with enrollment of participants, screen all enrollment paperwork for accuracy and completion.
• Work with Client Service Supervisor to organize assigned group service meetings and open enrollment for the most economical and effective use of time.
• Research and respond to WGAT and PCMI participant claim and administration questions utilizing the Health Care Processing system and the CTSR web-based tool(s).
• Determine necessary corrective action for problem/issue resolution using established documentation procedures and protocol.
• Request Benefits Information Booklet and Benefit Summaries/SBCs for health benefit information specific to each account.
• Support Regional Sales Manager/Account Manager/Broker/Client with plan comparisons, pre-filled enrollment/waiver forms, and any other materials or requests as needed.
• Attend employee client events to assist with benefits inquiries, provide materials to plan participants, and promote and enroll plan participants in value-added programs.
• Compile and track data pertaining to problems/issues, action taken and resolutions using the CTSR web-based tool.
• Document all services to include; enrollments, service meetings, employee client events, wellness events, courtesy calls and visits utilizing the CTSR web-based tool.
• Generate reports on metrics and suggest improvements to processes.
• Maintain a clean DMV record and the ability to travel to locations throughout the U.S. (mainly California and Arizona) up to 40% of the time.

Job description

Western Growers Health is seeking a Client Service Representative I to manage enrollment, implementation and education of WGAT and PCMI health plans. You will collaborate with vendors and support plan participants at group sites via phone or virtual platforms.

You will conduct bilingual group presentations in English and Spanish, assist with enrollment paperwork, answer benefits questions, and generate reports to improve service delivery.