Remote
Description
Western Growers Health─a part of Western Growers Family of Companies─provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry.
Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who 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 Western Growers Health today!
Compensation: $39,208- $55,972 with a rich benefits package that includes profit-sharing.
Job Description Summary
The Client Service Representative I (CTSR) reports directly 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. (PCMI) health benefit plan participants. This position also involves collaborating with third-party vendors related to employee health benefits. This includes the investigation of problems/issues to determine the 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 Diploma or equivalent, with 1-3 years of experience in customer service, preferred.
- Fluency in Spanish is required, and the ability to use Spanish for up to 70 % of the time.
- Intermediate knowledge of computer software programs to access and/or update customer records.
- Intermediate knowledge of Word, Excel, Outlook, and PowerPoint.
- Strong verbal and written communication skills in English and Spanish, with the ability to present information clearly in both languages.
- 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 30% of the 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 virtual platforms.
- Conduct group benefits presentations in both English and Spanish for WGAT and PCMI plan participants.
- Interface with third party vendors/providers to communicate and educate them on benefits and programs specific to WGAT plan participants.
- Provide one-on-one support to address applicant concerns or questions.
- Serve as the primary contact for questions regarding benefits utilization.
Member Services
- Assist with enrollment of participants, screen all enrollment paperwork for accuracy and completion.
- Work with Client Service Supervisor to organize assigned group service meetings and open enrollment for the most economical and effective use of time.
- Research and respond to WGAT and PCMI participant claim and administration questions utilizing the Health Care Processing system and the CTSR web-based tool(s).
- Determine necessary corrective action for problem/issue resolution using established documentation procedures and protocol.
- Request Benefits Information Booklet and Benefit Summaries/SBCs for health benefit information specific to each account.
- Support Regional Sales Manager/Account Manager/Broker/Client with plan comparisons, pre-filled enrollment/waiver forms, and any other materials or requests as needed.
- Attend employee client events to assist with benefits inquiries, provide materials to plan participants, and promote and enroll plan participants in value-added programs.
Data Collection
- Compile and track data pertaining to problems/issues, action taken and resolutions using the CTSR web-based tool.
- Document all services to include; enrollments, service meetings, employee client events, wellness events, courtesy calls and visits utilizing the CTSR web-based tool.
- Generate reports on metrics and suggest improvements to processes.
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 U.S. (mainly California and Arizona) up to 30% of the time.
- Other duties as assigned.
