Enrollment & Eligibility Specialist I

Western Growers; Irvine (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Western Growers is seeking an Eligibility Specialist I to manage enrollment and billing for Child Care Providers United on the HCPS portal. You will deliver superior customer service, guide providers on eligibility issues, and ensure HIPAA-compliant handling of sensitive data.

The role emphasizes accurate processing of enrollment transactions, timely documentation, and collaboration with internal teams to resolve discrepancies and improve processes.

Qualifications

• High school diploma or equivalent and 1–3 years accounting/business experience.
• Knowledge of HIPAA and ERISA regulations.
• Strong Microsoft Word, Excel, and Outlook skills.
• Experience delivering customer service via email and phone.
• Ability to research and resolve technical issues with minimal direction.
• Excellent written and oral communication skills.
• Ability to prioritize, multi-task, and work independently.
• General knowledge of health insurance operations.
• Spanish language proficiency (read/write/speak) required.

Responsibilities

• Maintain eligibility for CCPU accounts, including electronically submitted cases.
• Process enrollment transactions in HCPS from various sources per guidelines.
• Produce electronic reports and spreadsheets for audits and processing.
• Research and resolve account and billing issues; explain reimbursements to clients.
• Ensure HIPAA-compliant workstation and data protection.
• Meet processing cycle times and production deadlines.
• Suggest process improvements to reduce risk and costs.
• Create and document SOPs annually.
• Provide timely customer service and interface with internal/ external contacts.
• Contribute to team goals and other duties as assigned.

Skills

Accounting knowledge (GAAP)

HIPAA/ERISA knowledge

MS Office (Word/Excel/Outlook)

Customer service experience

Problem solving

Communication skills

Time management

Health insurance knowledge

Spanish language

Education

High school diploma or equivalent and 1–3 years accounting/business experience

Job description

Western Growers is seeking an Eligibility Specialist I to manage enrollment and billing for Child Care Providers United on the HCPS portal. You will deliver superior customer service, guide providers on eligibility issues, and ensure HIPAA-compliant handling of sensitive data.

The role emphasizes accurate processing of enrollment transactions, timely documentation, and collaboration with internal teams to resolve discrepancies and improve processes.