CCSB Call Center Representative I

Western Growers; United States; Hybrid; USD 38,625 - 48,750; Full time

Benefits offered by this job

Flexible work arrangements

Comprehensive benefits package

Profit-sharing opportunities

Job summary

Western Growers is seeking a Customer Advocate for our Pinnacle Small Business Call Center. This role involves providing consultative telephonic and web-based assistance, fostering relationships with various stakeholders, and ensuring compliance with call center quality guidelines.

The ideal candidate should have customer service experience, preferably in the healthcare sector. Strong communication and time management skills are essential. With competitive pay and flexible work arrangements, this is a great opportunity for growth and success.

Qualifications

• 1-3 years of customer service experience in a call center environment.
• Experience in the healthcare industry or federal/state programs is a plus.
• Strong written and verbal communication skills.

Responsibilities

• Provide comprehensive telephonic and web-based assistance.
• Foster relationships with agents and governmental agencies.
• Document information and activities thoroughly for accuracy.

Skills

Communication skills

Time management

Bilingual abilities

Education

High School diploma or GED

Tools

CRM software

Job description

Overview

If you’re looking for a career that provides affordable health benefit solutions to the people who support some of the most vital industries, we’re looking for you. At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees. As a keystone of our philosophy, we recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Additionally, employees are encouraged to recognize that there isn’t a work life and a home life, there is one life. This recognition throughout the organization emphasizes the value of finding a healthy and happy balance in every employee’s life. One way this is realized for employees of Pinnacle Claims Management is flexible work arrangements with work-from-home, in-office or hybrid options. With competitive compensation packages, premier investment support, enriching personal development and more, we strive for our employees’ job satisfaction and success. Compensation: $38,625.60- $48,750 with a rich benefits package that includes profit-sharing.

Job Description Summary: Position reports directly to the Supervisor, Pinnacle Small Business Call Center (CCSB). This position provides consultative telephonic and web-based assistance to Agents, Certified Enrollment Counselors, Qualified Health Plans (QHP), federal and state agencies and other stakeholders in Health Benefit Exchange administration. The incumbent will provide customer service support to clients by instructing them on correct eligibility management procedures and troubleshoot application issues and concerns.

Responsibilities

• Customer Advocate: Foster and build working relationships with Agents, Certified Enrollment Counselors, federal and state agency contacts. Become the subject matter expert for PCMI, State Provided Programs and HealthCare.Gov, and serve as a representative of the Agent with professionalism, knowledge, and discretion in all interactions.
• Call Center Support: Adhere to the call center Quality Guidelines to ensure the best phone support to our callers. Be a key contributor to meeting contractual obligations to PCMI. Meet and maintain all department service metrics and performance objectives.
• Documentation and Outreach: Thoroughly document information, activities and changes in the database and inquiry outcomes for accurate tracking and analysis. Provide telephonic and web-based outreach to assist with all aspects of the application process within the Covered California systems from sign up to termination.
• Process Improvement: Identify, initiate, and implement at least one process improvement and/or innovation annually.
• Other: Utilize all capabilities to satisfy one mission—to enhance the competitiveness and profitability of our members. Help members succeed by being curious, planning and executing work collaboratively. Maintain HIPAA-compliant workstation and security practices; maintain safety equipment where applicable.

Qualifications

• High School diploma or GED and one to three years of experience in customer service within a call center environment, preferably in a technical support role.
• Experience in the healthcare industry, especially with a health benefits company or a federal/state benefit program is a plus.
• Knowledge of Health Benefits Exchange (HBEX), eligibility requirements and the application/enrollment processes preferred.
• Strong written and verbal communication skills, including a clear speaking voice and active listening.
• Demonstrated skills in time management and teamwork; ability to research and resolve technical issues with minimal direction.
• Knowledge of government regulations and health benefit programs preferred.
• Ability to learn new software and navigate multiple systems; strong knowledge of CRM software.
• Basic computer skills and keyboarding; bilingual abilities in Spanish, Chinese, Korean, or Vietnamese are a plus.
• Internet access with minimum speeds of 40 Mbps download and 10 Mbps upload; wired Ethernet required for home router (wireless connections and hotspots not permitted).

Physical Demands and Work Environment

The physical demands and work environment described here represent those required to successfully perform this job’s essential functions. Reasonable accommodations may be made for individuals with disabilities. The role requires regular communication with others, movement around the office, and use of tools/controls. The typical noise level is moderate.

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