Remote Call Center Clerk – Admin & Claims Support

Western Growers Health; Irvine (CA); Remote; USD 41,000 - 53,000; Full time

Job summary

Western Growers Assurance Trust (WGAT) and Pinnacle Claims Management (PCMI) are seeking a Call Center Clerk to support the Customer Service team. This fully remote role handles clerical tasks, routing correspondence, prescreening documents, and HIPAA-compliant handling, with some Irvine, CA coordination.

Ideal candidates hold a high school diploma, have 2+ years in office administration (including call center experience), and strong organizational and communication skills.

Qualifications

• High School diploma or equivalent and two (2) years of experience working as a professional office administrator with a minimum of one (1) year of experience within an inbound call center environment preferred.
• Strong organizational and time-management skills.
• Ability to work independently or as part of a team.
• Intermediate knowledge of health insurance claims processing preferred.
• Strong knowledge of HIPAA rules and regulations to manage requests.
• Bilingual in Spanish preferred.

Responsibilities

• Review, respond to, and process daily clerical inquiries via fax, mail, email, and queues.
• Prescreen claim documents for validation and accuracy prior to processing.
• Cross-reference claims and correspondence from providers and members for accuracy.
• Prepare routine reports and assist with ad hoc projects for the Senior Supervisor.
• Lead escalated inquiries regarding billing issues and document routing.
• Operate HCPS and imaging systems to extract information while maintaining HIPAA compliance.

Skills

Strong organizational skills

Time-management

Independent worker

Communication skills (verbal and écrit

HIPAA knowledge

Bilingual in Spanish

Education

High School diploma or equivalent

Two years in professional office administration

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Western Growers Assurance Trust (WGAT) and Pinnacle Claims Management (PCMI) are seeking a Call Center Clerk to support the Customer Service team. This fully remote role handles clerical tasks, routing correspondence, prescreening documents, and HIPAA-compliant handling, with some Irvine, CA coordination.

Ideal candidates hold a high school diploma, have 2+ years in office administration (including call center experience), and strong organizational and communication skills.