Remote Eligibility & Billing Specialist II

Western Growers Health; Irvine (CA); Remote; USD 41,000 - 53,000; Full time

Job summary

Western Growers Health is seeking an Eligibility Specialist II to process enrollment and billing transactions, assist clients with eligibility and billing inquiries, and maintain HIPAA-compliant data security. You will work remotely with access to the Irvine office as needed.

The role emphasizes accuracy, compliance, and service excellence, with opportunities to improve processes and SOPs while supporting coordination across departments and vendors.

Qualifications

• High School diploma or equivalent with 3–5 years of accounting/business experience.
• Experience with HIPAA, COBRA, Cal-COBRA and ERISA.
• Proficiency in Microsoft Office (Word, Outlook, PowerPoint, Excel).
• Ability to analyze and resolve billing and eligibility issues.
• Bilingual Spanish a plus.

Responsibilities

• Process enrollment and billing transactions (adds, changes, terminations) in HCPS and via EDI.
• Research and resolve cash application and reconciliation issues.
• Provide customer service to clients via phone and email; explain eligibility and billing matters.
• Maintain HIPAA-compliant workstation and data security.
• Identify process improvements and document SOPs.

Skills

HIPAA knowledge

Microsoft Office

Customer service

Problem solving

Time management

Education

High School diploma or equivalent

Tools

HCPS

EDI systems

Genesys

Job description

Western Growers Health is seeking an Eligibility Specialist II to process enrollment and billing transactions, assist clients with eligibility and billing inquiries, and maintain HIPAA-compliant data security. You will work remotely with access to the Irvine office as needed.

The role emphasizes accuracy, compliance, and service excellence, with opportunities to improve processes and SOPs while supporting coordination across departments and vendors.