Billing Eligibility Specialist (Temp)

Neighborhood-Healthcare; Escondido (CA); Hybrid; USD 32,000 - 44,000; Full time

Job summary

Neighborhood Healthcare in Escondido, CA is seeking a Billing Eligibility Specialist to support patients with insurance eligibility issues and resolve billing concerns. The role manages insurance verification and eligibility in eCW, with a typical hybrid schedule and a tentative end date of 04/28/2027.

Candidates need a high school diploma or GED, EHR experience (eCW preferred), and bilingual English/Spanish as required by site. The role requires strong communication and teamwork.

Qualifications

• High school diploma or GED is required.
• Experience with electronic health record systems (eCW preferred).
• Two years medical front office experience is preferred.
• Bilingual English/Spanish as site requires.
• Medical Office Assistant certification is preferred.

Responsibilities

• Verifies insurance eligibility and adds notes in eCW.
• Performs batch and individual eligibility verifications in eCW.
• Submits electronic insurance verifications via eCW, portals, or insurer calls.
• Maintains knowledge of contracted insurances and programs accepted at Neighborhood Healthcare.
• Provides direct support to clinics regarding eligibility inquiries and billing processes.
• Validates insurance eligibility, benefits, and financial information for billing and collection processes.
• Initiates three-way calls with patients and insurance carriers for PCP changes.
• Informs patients of benefits and financial responsibilities as needed.
• Applies Sliding Fee Discount Program (SFDP) discounts as necessary.
• Ensures income documentation is secured and valid.

Skills

Verbal and written communication

Multitasking

HIPAA compliance

Bilingual English/Spanish

Education

High school diploma/GED

Medical Office Assistant certification

Tools

eCW (Electronic Health Record)

Job description

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

ROLE OVERVIEW and PURPOSE

The Billing Eligibility Specialist works to support the mission and vision of Neighborhood Healthcare by assisting patients with insurance eligibility issues. This role will confirm and work with patients to resolve billing and insurance related issues. In addition, this role will manage the insurance verification and eligibility functions in eCW.

This position is temporary, and the assigned end date of 04/28/2027 is tentative.

**Please note, this is a hybrid role and the typical schedule for this position is Monday through Friday, 7 AM to 4 PM with a 1-hour lunch break.**

RESPONSIBILITIES

• Completes insurance verifications and places electronic notes in eCW accurately and timely
• Performs batch and individual eligibility verifications utilizing the Insurance Eligibility (IE) function in eCW
• Submits electronic insurance verifications through eCW, insurance website portals, or calls insurance companies to inquire about eligibility, benefits information, and payment for services
• Maintains knowledge of all contracted insurances and programs accepted at NHC
• Provides direct support to clinics regarding eligibility inquiries
• Validates insurance eligibility, benefits, and financial information required for billing and collection processes
• Completes a high volume of benefit verification requests
• Initiates three-way calls with patients and insurance carriers to perform primary care provider (PCP) changes
• Informs patients of their benefits and financial responsibilities, as needed
• Applies Sliding Fee Discount Program (SFDP) discounts to patient changes, as necessary
• Validates declaration of income documentation is secured and valid
• Provides thorough customer service internally and externally with professionalism, courtesy, and knowledge
• Participates in various projects and team meetings

EDUCATION/EXPERIENCE

• High school diploma/GED required
• One year electronic health record systems is required; eCW is preferred
• Two years’ medical front office experience is preferred
• Medical Office Assistant certification is preferred
• Bilingual (English/Spanish) as required by site

ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities)

• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Knowledgeable about and experience with medical office procedures and billing insurance carriers, including Medicare and Medicaid
• Knowledgeable about insurance eligibility processes and coverage guidelines for multiple carriers
• Ability to successfully manage multiple tasks simultaneously
• Excellent planning and organizational ability
• Ability to work as part of a team as well as independently
• Ability to work with highly confidential information in a professional and ethical manner

Physical Requirements

• Ability to lift/carry 50 lbs/weight
• Ability to stand for long periods of time

COMPLIANCE (Safety & HIPAA)

• Follow all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately
• Maintain current knowledge of policies and procedures as they relate to safe work practices
• Follow all safety procedures and report unsafe conditions
• Use appropriate body mechanics to ensure an injury free environment
• Be familiar with location of nearest fire extinguisher and emergency exits
• Follow all infection control procedures including blood-borne pathogen protocols
• Maintain privacy of all patient, employee and volunteer information and access such information only on a need-to-know basis for business purposes
• Comply with all regulations regarding corporate integrity and security obligations
• Report all behavior and/or activity that are unethical, fraudulent, or unlawful

Pay Range: $22.88 - $32.08 per hour, depending on experience.

Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.