Enrollment & Billing Specialist II — Client-Focused Expert

Western Growers Assurance Trust; Irvine (CA); On-site; USD 48,000 - 72,000; Full time

Job summary

Western Growers Assurance Trust is seeking an Eligibility Specialist II to process enrollment and billing tasks, assist clients with inquiries, and resolve discrepancies in HCPS and PCMI systems. You will handle EDI transactions, cash applications, and reconciliations while ensuring HIPAA compliance and data security.

The role emphasizes accuracy, efficiency, and collaboration across departments to support member organizations and maintain strong service levels.

Qualifications

• High School diploma or equivalent and 3–5 years of accounting/business experience.
• Knowledge of healthcare eligibility and billing procedures incl HIPAA, COBRA, Cal-COBRA and ERISA.
• Proficiency with Microsoft Office products.
• Experience with EDI file updates in a legacy system.
• Customer service experience via email and telephone.
• Excellent written and oral communication skills.
• Strong time management and ability to meet deadlines.
• Health insurance operations knowledge; bilingual Spanish a plus.
• Overtime flexibility and ability to work independently or in a team.

Responsibilities

• Process enrollment transactions (adds, changes, terminations) and billing items.
• Research and resolve cash application issues and reconcile ledgers.
• Provide timely customer service on enrollment and billing inquiries.
• Interface with internal departments and external vendors to resolve issues.
• Create SOPs and identify process improvements for efficiency and compliance.
• Maintain HIPAA-compliant workstation and protect confidential data.
• Meet performance and audit standards; document and follow procedures.

Skills

Microsoft Office

HIPAA knowledge

EDI processing

Customer service

Written communication

Time management

Health insurance operations

Spanish bilingual

Education

High School diploma or equivalent

Tools

Microsoft Office Suite (Word, Outlook, PowerPoint, Excel)

Job description

Western Growers Assurance Trust is seeking an Eligibility Specialist II to process enrollment and billing tasks, assist clients with inquiries, and resolve discrepancies in HCPS and PCMI systems. You will handle EDI transactions, cash applications, and reconciliations while ensuring HIPAA compliance and data security.

The role emphasizes accuracy, efficiency, and collaboration across departments to support member organizations and maintain strong service levels.