Jobs at Pinnacle Claims Management, Inc.

Owns the sales-to-implementation transition for new and upsold health plan business. Leads requirements discovery, validates scope and documentation, coordinates brokers, clients, Sales, Installation, and operational teams, identifies implementation risks, and ensures readiness for handoff. Maintains tracking tools and dashboards, monitors deadlines and outstanding requirements, improves workflows, supports revenue activation, and trains stakeholders on onboarding and documentation standards.

Supports sales operations through recurring reporting, commission analysis, renewal and new business reporting, Salesforce data maintenance, dashboard support, and Excel-based reconciliation. Maintains templates, validates data, troubleshoots reporting issues, documents processes, supports users, and identifies opportunities for automation and process improvement. Partners with sales, operations, reporting, and technology teams to improve reporting accuracy, data integrity, and operational efficiency.

Processes healthcare eligibility enrollments, changes, terminations, billing transactions, reimbursements, refunds, and account corrections in CCPU Portal and HCPS. Supports providers and clients by resolving eligibility and billing issues, producing reports, maintaining HIPAA-compliant data security, and coordinating with internal teams and external contacts. The role also contributes to process improvements, SOP documentation, and timely transaction processing.

Manages employer benefits customer accounts for a third-party administrator, supporting implementation, administration, renewals, client and broker needs, and issue resolution. Advises on self-funded plans, pharmacy benefits, wellness, care management, and ancillary products. Analyzes claims and pharmacy data to identify cross-selling opportunities, collaborates with Sales on proposals, and maintains compliance with relevant healthcare regulations. Requires a California Life and Health insurance license and travel up to 30%.