CCSB Call Center Representative I

Summary: Pinnacle Claims Management is an innovative third-party administrator providing health benefits solutions. The CCSB Call Center Representative I role involves providing consultative telephonic and web-based assistance to clients and stakeholders in Health Benefit Exchange administration, ensuring excellent customer service and support. Responsibilities: - Foster and build working relationships with Agents, Certified Enrollment Counselors, federal and state agency contacts - Must become the subject matter expert for PCMI, State Provided Programs and HealthCare.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 document information, activities and changes in the database and inquiry outcomes for accurate tracking and analysis - Provide telephonic and web-based outreach to provide informational support to assist with all aspects of the application process within the Covered California systems from sign up to termination - Identify, initiate, and implement at least one process improvement and/or innovation annually - 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 helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, be self-accountable, create a positive impact, and be diligent in delivering results - Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet - Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data - Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit) - All other duties as assigned Required Qualifications: - High School diploma or GED - One (1) to three (3) years of experience in customer service within a call center environment, preferably within a technical support role - Strong written and verbal communication skills, including a very 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 as they arise with minimal direction - Ability to retain and apply knowledge of the various operations of the organization, products, and services, in order to provide excellent customer service support - Ability to learn new software and navigate multiple systems at once - Must have strong knowledge of Customer Relationship Management (CRM) software - Ability to adapt to a constantly changing environment - Basic computer experience and keyboarding skills - 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 Preferred Qualifications: - Experience in the healthcare industry especially with a health benefits company or a federal, state benefit program - Knowledge of Health Benefits Exchange (HBEX), eligibility requirements and the application and enrollment processes - Knowledge of government regulations, federal, state, and local health benefit programs - Bilingual in Spanish, Chinese, Korean, and Vietnamese Required Skills: Call Center Experience, Health Benefits Exchange (HBEX) Knowledge, Eligibility Management, Application and Enrollment Processes, Technical Support, Healthcare Industry Knowledge, Government Regulations Knowledge, Customer Relationship Management (CRM) Software, Bilingual Spanish, Bilingual Chinese, Bilingual Korean, Bilingual Vietnamese Benefits: Flexible work arrangements with work-from-home, in-office or hybrid options, Rich benefits package that includes profit-sharing