Customer Service Representative I

Customer Service Irvine, California


Description

Western Growers Assurance Trust (WGAT) was founded in 1957 to provide a solution to a need in the agricultural community — a need for employer-sponsored health benefit plans not previously available from commercial health insurance carriers. WGAT is now the largest provider of health benefits for the agriculture industry. The sponsoring organization of WGAT is Western Growers Association, created in 1926 to support the business interests of employers inthe agriculture industry. WGAT’s headquarters is located in Irvine, California.

WGAT’s mission is to deliver value to agriculture-based employer groups by offering robust health plans that meet the needs of a diverse workforce. By working at WGAT, you will join a dedicated team of employees who truly care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to WGAT today!

To learn more watch our Company Video

Job Description Summary

Under the direction of the Customer Service Supervisor, 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 required.
  • Knowledge of Health Benefits and eligibility preferred.
  • Good communication and telephone skills with a very clear and concise speaking voice
  • Proficient written communications 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.

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 provides information/solutions.
  • Research and resolve aged Customer Service open calls within company standards.
  • Develop and maintains positive customer relations and coordinates 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.
  • Operate in the Health Care Processing System (HCPS), Imaging systems, and all systems necessary to obtain and extract information.
  • Meet and maintain Quality and Telephone Performance measures per Customer Service Performance Report
  • Communicate with the appropriate departments and identifies service issues.

Other

  • Maintain regular attendance per employee handbook guidelines.
  • Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. This job exists to serve directly (or indirectly) to someone in the fresh produce industry. 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.
  • 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 associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the associate is regularly required to talk or hear. The associate frequently is required to stand, walk and sit. The associate is frequently required to use hands to finger, handle, or feel objects, tools, or controls and reach with hands and arms. The noise level in the work environment is usually moderate.