Call Center Representative ; California

Company Overview

At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees.

We recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Employees are encouraged to recognize that there isn’t a work life and a home life, there is one life, emphasising the value of a healthy and happy balance. Flexible work arrangements include work‑from‑home, in‑office or hybrid options.

With competitive compensation packages, premier investment support, enriching personal development and more, we strive for our employees’ job satisfaction and success.

$38,625.60 – $50,874.31 with a rich benefits package that includes profit‑sharing.

The CCSB Call Center Representative I will be at the forefront of providing exceptional customer service and technical support. This role is responsible to work with a diverse group of stakeholders, including Covered California Certified Insurance Agents and Certified Enrollment Counselors. The Call Center Representative I will play a crucial role in assisting clients over the phone and electronically, making a real difference in their experience with the Health Benefits Exchange (HBEX).

• High School diploma or GED with 1‑3 years in customer service, preferably in a technical support role within a call center environment, preferred.
• Excellent communication, time management, and team‑building skills. Capable of researching and resolving technical issues independently or with minimal support.
• Proficiency in Microsoft products, including but not limited to Word, Teams, and Outlook, for data entry and information processing.
• Ability to learn new software and navigate multiple systems ong knowledge of Customer Relationship Management (CRM) software. Basic computer experience and keyboarding skills.
• Ability to adapt to a constantly changing environment.
• Knowledge of government regulations, federal, state, and local health benefit programs are preferred.
• Strong written and verbal communication skills, including a clear and concise speaking voice and active listening.
• Bilingual in Spanish, Chinese, Korean, or Vietnamese is a plus.
• 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.

• Manage inbound calls in a timely and professional manner. Address customer inquiries, provide accurate information, and resolve issues.
• Build and maintain relationships with Agents, Certified Enrollment Counselors, and federal and state agency contacts.
• Become a subject matter expert in HBEX, State Provided Programs, and Health Care.
  
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• Serve as a representative of the Agent by displaying professionalism, knowledge, and discretion in all interactions with other members of the Agent’s community and their customers.
• Enhance the Customer Experience by continuously looking for ways to improve the overall customer experience.
• Maintain composure, manage emotions, and avoid aggressive behavior, even in difficult situations.
• Adhere to the call center Quality Guidelines to ensure the best phone support for our callers.
• Stay adaptable in a constantly changing environment.
• Accept criticism and handle high‑stress situations calmly and effectively.

• Provide telephonic and web-based outreach to assist with all aspects of the application process within the Covered California…