CCSB Call Center Representative

If you’re looking for a career that provides affordable health benefit solutions to the people who support some of the most vital industries, we’re looking for you.

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.

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. This emphasis on a healthy and happy balance is realized through flexible work arrangements with 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–$48,750 with a rich benefits package that includes profit‑sharing.

The position reports directly to the Supervisor, Pinnacle Small Business Call Center (CCSB). The role provides consultative telephonic and web‑based assistance to Agents, Certified Enrollment Counselors, Qualified Health Plans (QHP), federal and state agencies and other stakeholders in Health Benefit Exchange administration. The incumbent will provide customer service support to clients by instructing them on correct eligibility management procedures and troubleshooting application issues and concerns.

• High School diploma or GED and 1–3 years of experience in customer service within a call center environment, preferably within a technical support role.
• Experience in the healthcare industry, especially with a health benefits company or a federal/state benefit program, is a plus.
• Knowledge of Health Benefits Exchange (HBEX), eligibility requirements and the application and enrollment processes preferred.
• Strong written and verbal communication skills, including a clear and concise speaking voice and active listening.
• Demonstrated skills in time management and team building.
• Strong ability to research and resolve technical issues and/or client problems with minimal direction.
• Knowledge of government regulations, federal, state, and local health benefit programs preferred.
• Ability to retain and apply knowledge of the various operations of the organization, products, and services, to provide excellent customer service support.
• Ability to learn new software and navigate multiple systems t have strong knowledge of Customer Relationship Management (CRM) software.
• Ability to adapt to a constantly changing environment.
• Basic computer experience and keyboarding skills.
• Bilingual in Spanish, Chinese, Korean, and Vietnamese is a plus.
• Internet access provided by a cable or fiber provider with 40MB download and 10MB 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 toward wall).
• A functioning smoke detector, fire extinguisher, and first aid kit on site.

• Foster and build working relationships with Agents, Certified Enrollment Counselors, federal and state agency contacts.
• Become the subject matter expert for PCMI, State Provided Programs and Health Care.gov.
• 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.
• Adhere to the call center Quality Guidelines to ensure the best phone support to our callers.

• Be a key contributor to meeting our contractual obligations to PCMI.
• Meet and maintain all of the department service metrics and performance objectives.
• Thoroughly…