Lead CCSB Eligibility Specialist: Complex Cases Training

Western Growers; Irvine (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Western Growers in Irvine is seeking an experienced Eligibility Specialist III to determine eligibility for employee benefit plans within the CCSB exchange, handling escalations and complex cases. You will train less experienced staff and ensure regulatory compliance across processes.

The role requires strong analytical skills, billing/eligibility system proficiency, and the ability to lead a small team while coordinating with internal departments and external partners.

Qualifications

• BA/BS degree in accounting, finance, or related field with 5–7 years accounting/business experience preferred.
• Detail-oriented with ability to prioritize, multi-task, and work independently in a team.
• Strong HIPAA, COBRA, MEWA, ERISA knowledge and health care eligibility experience.
• Audit procedures knowledge and ability to assist audit teams.
• Proficiency in Microsoft Office; customer service via email and phone.
• Ability to train and lead a team; excellent written and oral communication.
• Overtime may be required; reliable internet with approved home setup.
• Spanish language skills are a plus.

Responsibilities

• Train and mentor new team members; provide ongoing support and guidance.
• Maintain eligibility and billing for CCSB accounts; support call center.
• Review eligibility changes per agreements and guidelines; resolve escalations.
• Collaborate with leadership, vendors, and clients to address issues.
• Generate reports and ensure adherence to SLAs and processing timelines.
• Serve as SME for troubleshooting escalations and client communications.

Skills

Detail-oriented

Analytical thinking

Customer service

Training others

Communication skills

Overtime flexibility

Education

BA/BS in accounting, finance, or related field

Tools

Microsoft Office Suite

Eligibility software systems

Case management tools

Job description

Western Growers in Irvine is seeking an experienced Eligibility Specialist III to determine eligibility for employee benefit plans within the CCSB exchange, handling escalations and complex cases. You will train less experienced staff and ensure regulatory compliance across processes.

The role requires strong analytical skills, billing/eligibility system proficiency, and the ability to lead a small team while coordinating with internal departments and external partners.