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Customer Service Representative (Customer Service)
Irvine, CA 92618
Recruited by: Rhonda Linsday | Recruiter | Pinnacle Claims Management, Inc. See all my Jobs

  • Hiring Company: Pinnacel Claims Management Inc
  • Industry: Customer Service
  • Compensation: to be determined
  • Expires: Feb 10, 17
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Job Description

The mission of the Western Growers Association is to enhance the competitiveness and profitability of our members in California, Arizona and Colorado; the farmers who grow, pack and ship almost 50% of our nation's produce. We accomplish this by providing products and services with agriculture in mind. Our services include ACA compliant health benefits for farm workers, cost-saving and environmentally-focused logistics, food safety initiatives and advocacy for our members. We continue to focus on what’s important to our members: sustainability, entrepreneurship and the health of our people and our land. As our members adapt to an ever-changing market and environmental landscape, so do we.

If you are looking to be a part of something important — growing food for America — and thrive in a fast-paced, leading-edge environment, Western Growers might be just the fit for you.

We offer an extensive benefits package which includes competitive salaries, a wide selection of health benefits, excellent 401K plan which includes up to 3% matching employee contribution and 7% discretionary profit sharing, education reimbursement program, and much more.

JOB DESCRIPTION SUMMARY:
Under the direction of the Supervisor, Customer Service, this position will perform various administrative duties to support the customer service team. This role will also serve as back-up for telephone and web based member and provider inquiries in accordance with company policies and procedures.

QUALIFICATIONS:
The following qualifications are preferred to successfully accomplish this position:

A. High School diploma or GED
B. One (1) year experience in professional office administrative role or minimum one (1) year of experience working in an inbound call center environment
C. Knowledge of health insurance claims process preferred
D. Intermediate computing and keyboarding skills with end user office software
E. Possess good verbal and written communication skills
F. Demonstrated skills in time management and team work support
G. Knowledge of Health Insurance Portability and Accountability Act (HIPPA) rule and regulations, preferred
H. Ability to lift unrestricted weight of 25 lbs.

DUTIES AND RESPONSIBILITIES:
A. Gather daily claims inquires and general correspondence via fax and email for team distribution.
B. Prescreen claim documents to ensure validation and accuracy prior to processing.
C. Cross-reference all claims and correspondence.
D. Process customer service representative form requests.
E. Resolve customer service check tracers with internal/external sources.
F. Track various department requests and claims distributed to the Claims department.
G. Capture and maintain a status report on all calls/requests submitted to other departments and follow ups.
H. Provide back-up support for customer service department.
I. Prepare routine reports and assist the supervisor with special projects as assigned.
J. Maintain the department filing/notes, calendar and schedules.
K. Work overtime as needed.
L. Get curious and strive to understand others’ outside triangles, (what they are needing/wanting to do).
M. Plan and execute work in a helpful and collaborative manner
N. Be accountable for actually helping, assess and report performance in terms of impact, making improvements, and course correcting along the way
O. Other duties as assigned