Remote Insurance Benefits Advocate

Western Growers; Irvine (CA); On-site; USD 52,000 - 68,000; Full time

Job summary

Western Growers in Irvine, CA seeks a customer service professional to respond to inquiries about insurance benefits, contracts, and reimbursement programs. The role emphasizes confidentiality, accuracy, and timely handling of member, provider, and employer questions.

The candidate will research and analyze data to resolve standard operational challenges within Customer Service and maintain HIPAA-compliant workstation practices on-site.

Qualifications

• High School diploma or GED and/or one to three years of experience in customer service within a call center environment, preferred.
• Knowledge of Health Benefits and eligibility preferred.
• Good communication and telephone skills with a very clear and concise speaking voice.
• Proficient written communication skills with the ability to learn new software and navigate multiple systems at once.

Responsibilities

• Respond to general customer questions via telephone, e-mail, and written correspondence regarding insurance benefits, provider contracts, reimbursement programs, eligibility, and claims in a confidential, professional, and ethical manner.
• Analyze problems and provide information/solutions.
• Research and resolve aged Customer Service open calls within company standards.
• Operate in the Health Care Processing System (HCPS), Imaging systems, and all systems necessary to obtain and extract information with proficiency and skills.
• Develop and maintain positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Be accountable when you uncover an issue or trend by helping to assess and report its impact, making improvements, and course-correcting along the way.
• Follow quality guidelines to provide exceptional customer support and ensure scores meet or

Skills

Communication skills

Health benefits knowledge

Bilingual Spanish (preferred)

Written communication

Time management

Research and problem solving

HIPAA compliance familiarity

Education

High School diploma or GED

Tools

HCPS

Imaging systems

Job description

Western Growers in Irvine, CA seeks a customer service professional to respond to inquiries about insurance benefits, contracts, and reimbursement programs. The role emphasizes confidentiality, accuracy, and timely handling of member, provider, and employer questions.

The candidate will research and analyze data to resolve standard operational challenges within Customer Service and maintain HIPAA-compliant workstation practices on-site.