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Customer Service Representative I

Remote:

Full Remote

Contract:

Full time

Salary:

39 - 49K yearly

Experience:

Mid-level (2-5 years)

Work from:

California (USA), United States

Offer summary

Qualifications:

High School diploma or GED required, Two years of customer service experience preferred, Knowledge of Health Benefits preferred, Proficient in written and verbal communication, Bilingual in Spanish preferred.

Key responsabilities:

Respond to customer inquiries professionally
Research and resolve customer service issues
Document information for accurate tracking
Ensure timely resolution of customer requests
Maintain HIPAA compliance and accountability

Pinnacle Claims Management, Inc.

201 - 500 Employees

See more Pinnacle Claims Management, Inc. offers

Job description

Description

You spend more than half of your waking hours working. Make these precious, fleeting moments matter by working for an organization and a cause you can believe in.

Western Growers exists for one reason only: to ensure the future viability of its members – the hard-working, salt-of-the-earth farmers who grow the fruits, vegetables and tree nuts that feed our nation and nourish our bodies.

Our members depend on us to help them remain competitive and profitable as they face challenges that make it increasingly difficult and expensive to do business. Our goal is to fight for them– heart and soul –every single day. We passionately advocate, facilitate technological advancements and provide insurance for our members. We do all of this, and more, from a position of leadership in the agriculture industry.

This mission requires a team of intelligent, inquisitive and innovative individuals connected for our common purpose.

The core company philosophy that strengthens our mission is that everything starts with people. Every employee of the organization has access to research-based training to encourage and support Outward Inclusion philosophy and our DEI initiatives. As an element of this training, 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 that is realized for employees of Western Growers is flexible work arrangements with work-from-home, in-office or hybrid options.

At Western Growers, we recognize and welcome the many qualities you can bring to the team.

Grow with us.

Compensation: $38,625.60 - $49,323 with a rich benefits package that includes profit-sharing.

Job Description Summary

Under the direction of the Senior Supervisor, Customer Service, this position is responsible for responding to general customer inquiries regarding insurance benefits, provider contracts, eligibility, and claims in a confidential, professional, and ethical manner. The incumbent will also be responsible for researching and analyzing data to address operational challenges and Customer Service department issues.

Qualifications

High School diploma or GED and a minimum of two (2) 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.
Moderate computing and keyboarding skills including proficiency with database management.
Ability to adapt to a constantly changing environment.
Proficient organizational and time management skills.
Fluent in English (oral and written) required. Bilingual in Spanish preferred.
Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
Home router with wired Ethernet (wireless connections and hotspots are not permitted).
A designated room for your office or steps taken to protect company information (e.g., facing computer towards wall, etc.)
A functioning smoke detector, fire extinguisher, and first aid kit on site.

Duties And Responsibilities

Customer Advocate

Respond to general customer questions via telephone, e-mail, and written correspondence regarding insurance benefits, provider contracts, 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.
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, for actually helping, assess and report what is happening in terms of impact, making improvements, and course correcting along the way.

Call Center Support

Thoroughly document information, activities, and changes in the database and inquiry outcomes for accurate tracking and analysis.
Research and analyze data to address operational challenges and customer service issues.
Provide external and internal customers with requested information, including difficult and upset customers.
Meet and maintain Quality and Telephone Performance measures per Customer Service Performance Report
Communicate with the appropriate departments and identify service issues.
Identify inefficiencies within the established processes and suggest possible solutions to save time, reduce risk, and/or reduce expenses.
Create and document a minimum of one new Standard Operating Procedure (SOP) annually.
Identify, initiate, and implement at least one process improvement and/or innovation annually.

Other

Maintain regular attendance per employee handbook guidelines.
Utilize 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 helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results.
Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet.
Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data.
Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit).
All other duties as assigned.

Physical Demands/Work Environment

The 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 move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate.

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