Client Service Representative

Field Services Imperial, California


Description

Job Description Summary

The Client Service Representative I reports 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. (Pinnacle) health benefit plan participants, as well as interfacing with third party vendors as they relate to employee health benefits.  This includes the investigation of problems/issues to determine source of the problem, evaluation of investigation results and determination of necessary corrective action for problem/issue resolution using established procedures and protocol. 

Qualifications

  • High school education or equivalent and a minimum one year of customer service experience preferred.
  • Spanish bilingual skills, oral and written preferred.
  • Basic knowledge of computer software programs to access and/or update customer records.
  • Basic knowledge in personal computer software skills in Word, Excel and PowerPoint.
  • Strong verbal, written and presentation communication skills in both English and Spanish.
  • 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 time.

 

Duties And Responsibilities

Education Services

  • Educate newly enrolled and existing plan participants on health plan and ancillary benefits at group’s work site locations, via phone or skype.
  • Interface with third party vendors/providers to communicate and educate them on benefits and programs specific to WGAT plan participants.

Member Services

  • Assist with enrollment of Trust participants’, screen all enrollment paperwork for accuracy and completion.
  • Work with Client Service Analyst to organize assigned group service meetings and open enrollment for the most economical and effective use of time.
  • Research and respond to WGAT participant claim and administration questions utilizing the WGAT Health Care Processing system and the FSR web based tool(s).
  • Determine necessary corrective action for problem/issue resolution using established documentation procedures and protocol.
  • Request Benefits Information Pamphlet and Benefit Summaries/SBCs for health benefit information specific to each WGAT account.
  • Support Regional Sales Manager/Account Manager/Broker with plan comparisons as needed.

Data Collection

  • Compile and track data pertaining to problems/issues, action taken and resolutions using the FSR web based tool.
  • Document all field services to include; enrollments, service meetings, wellness and courtesy calls and visits utilizing the FSR web based tool.

Other

  • 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 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 US (mainly California and Arizona) up to 40% of the time.
  • 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 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 employee is regularly required to talk or hear. The employee frequently is required to stand, walk and sit. The employee 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.