Client Services Representative I

Western Growers Assurance Trust; Fresno (CA); On-site; USD 38,000 - 52,000; Full time

Job summary

Western Growers Assurance Trust seeks a Client Service Representative I to support enrollment, implementation, and education of plan participants for WGAT and PCMI health benefits. The role involves collaborating with third-party vendors and addressing participant questions, primarily at client sites.

Responsibilities include educating participants in English and Spanish, processing enrollments, and providing information on benefits while maintaining accurate data in CTSR tools and reports.

Qualifications

• HS diploma or equivalent required.
• 1–3 years customer service experience preferred.
• Bilingual Spanish and English required for daily use.
• Strong written and verbal communication skills in both languages.

Responsibilities

• Educate participants about WGAT/PCMI benefits at worksites or remotely by phone or virtual sessions.
• Assist with enrollment, review paperwork for accuracy, and schedule meetings.
• Coordinate with vendors and internal teams to resolve benefits questions.
• Respond to inquiries about claims and benefits using CTSR tools.
• Generate reports on service metrics and provide process improvement ideas.
• Travel to client sites in the U.S. (primarily CA and AZ) up to 40%.

Skills

Customer service

Bilingual Spanish

Communication

Data entry

MS Office

Education

High School Diploma or equivalent

Tools

HealthCare System

CTSR web tool

Job description

JOB DESCRIPTION SUMMARYThe Client Service Representative I (CTSR) reports directly to the Supervisor of Client Services and is responsible for the enrollment, implementation, and education of Western Growers Assurance Trust (WGAT) and Pinnacle Claims Management. Inc. (PCMI) health benefit plan participants. This position also involves collaborating with third-party vendors related to employee health benefits. This includes the investigation of problems/issues to determine the source of the problem, evaluation of investigation results, and determination of necessary corrective action for problem/issue resolution using established procedures and protocol.DUTIES AND RESPONSIBILITIESEducation ServicesEducate 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.Member ServicesAssist 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.Data CollectionCompile 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.OtherUtilize 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 in a helpful and collaborative manner, being willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating positive impact, and being diligent in delivering results.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.Other duties as assigned.PHYSICAL DEMANDS/WORKENVIRONMENTThe 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 travel to both indoor and outdoor areas that can vary in exposure and temperature. The employee is frequently required to operate a motor vehicle, use objects, tools, or controls, and/or required to lift up to 50lbs. The noise level in the work environment is usually moderate.QUALIFICATIONSHigh School Diploma or equivalent, with 1-3 years of experience in customer service, preferred.Fluency in Spanish is required, and the ability to use Spanish for up to 70 % of the time.Intermediate knowledge of computer software programs to access and/or update customer records.Intermediate knowledge of Word, Excel, Outlook, and PowerPoint.Strong verbal and written communication skills in English and Spanish, with the ability to present information clearly in both languages.Ability to prioritize tasks and manage time effectively, with excellent follow-up skills.Verifiable, clean DMV record and the ability to travel to various locations throughout the U.S. up to 40% of the time.