Eligibility Specialist

The Eligibility Specialist is responsible for performing enrollment and billing functions necessary to maintain WGAT (Western Growers Assurance Trust) and PCMI (Pinnacle Claims Management, Inc.) accounts on the Healthcare Common Procedure Coding System (HCPS) as assigned. The role is also responsible for providing the highest level of customer service support to clients by instructing them on correct eligibility management and explaining billing/payment issues. Assist in maintaining Eligibility and Billing for WGAT & PCMI accounts as assigned including clients that submit eligibility electronically. Assist in producing electronic spreadsheets and/or reports for audit and processing purposes.Contact clients to explain and to resolve billing/payment discrepancies. Verify/authorize refunds for terminations and/or overpayments. Interface effectively with internal departments and external vendors, brokers or other business contacts.

According to JobzMall, the average salary range for a Eligibility Specialist in 15525 Sand Canyon Ave, Irvine, CA 92618, USA is between $36,000 and $45,000 per year. This range may vary depending on other factors such as experience and qualifications.

Founded in 1926, Western Growers represents local and regional family farmers growing fresh produce in Arizona, California, Colorado and New Mexico. Our members and their workers provide over half the nation's fresh fruits, vegetables and tree nuts, including nearly half of America's fresh organic produce.