Benefits

• Paid Time Off & Paid Company Holidays
• Medical, Dental, Vision & Life Insurance
• Flexible Spending Account (FSA)
• 403(b) Retirement Plan with Company Match
• Short-Term & Long-Term Disability
• $0 Copay for Legacy Provider visits
• $0 Copay for prescriptions filled at Legacy Pharmacies
• Travel Insurance & Pet Insurance
• Subsidized Gym Membership
• And much more!

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Location: Legacy Montrose Allen Parkway - 2929 Allen Pky, Houston, TX 77019

Lead Eligibility Specialist Bilingual - Montrose (Job Overview)

Schedule: Monday-Friday (8AM-5PM)

Join our family as an Eligibility Specialist Lead and help connect patients with the healthcare services they need. In this meaningful role, you will determine eligibility for third-party reimbursement, support new patient admissions, ensure accurate insurance billing codes, and respond to questions from prospective applicants and patients.

You will be a trusted resource for patients, teammates, and Management. Your compassion, organization, and attention to detail will help create a respectful, patient-centered experience, while your leadership will support a strong and capable Eligibility team across multiple clinic locations.

Why You’ll Make a Difference

• Help patients navigate eligibility, insurance coverage, and access to community healthcare services.
• Support accurate reimbursement and billing processes that strengthen the healthcare delivery system.
• Collaborate with teammates and Management to meet department goals and objectives.
• Provide guidance and first-line support for Eligibility situations when the manager is absent.
• Host training classes for newly hired departmental employees and assist with their learning process.
• Build relationships across multiple clinic locations while supporting consistent Eligibility operations.
• Participate in performance improvement activities, audits, safety education, and department projects.

A Meaningful Opportunity for Growth

This position is a great fit for someone who brings accountability, patience, and a genuine passion for helping people. You’ll have the opportunity to guide colleagues, strengthen department processes, and make a direct impact on patients’ ability to receive timely care. By remaining calm under pressure and working closely with others, you’ll help both patients and teammates feel supported and prepared.

• Make a daily difference in the lives of patients and families.
• Grow your leadership skills through training, coordination, and first-line departmental support.
• Contribute to a collaborative team environment centered on respect and service.
• Support the important connection between eligibility operations, accurate reimbursement, and healthcare access.

Key Responsibilities

• Conduct eligibility for clients following procedures and guidelines specific to each program.
• Confirm any additional client’s payer source such as Medicaid, Medicare, ADAP, and any other third party insurance.
• Register clients into the CPCDMS and manage record owner transfers when and if needed.
• Complete all necessary paperwork and perform data entry for eligible clients into the electronic system.
• Maintain up-to-date and orderly eligibility files.
• Conduct renewal eligibility as required by each program.
• Confirm eligibility appointments with clients and set initial service appointments once eligibility has been determined.
• Provide clients with a list of required eligibility documentation.
• Assist clients with Marketplace.
• Participate in the Performance Improvement Program.
• Demonstrate respect for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• Serve as the first-line contact in the manager’s absence regarding Eligibility situations.
• Monitor multiple clinic schedules on a daily basis.
• Complete site visits to multiple clinic locations to manage and assist the Eligibility Department when needed.
• Participate in external, internal, quarterly, and yearly audits.
• Host newly hired departmental employees’ Training Class and assist with the learning process.
• Assist Management with multiple reports based on program-specific needs.
• Assist with other projects, as needed.
• Promote effective working relationships and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives.
• Attend all required safety training programs and describe responsibilities related to general safety, department/service safety, and specific job-related hazards.
• Attend all required safety education programs.
• Operate assigned equipment and perform all procedures in a safe manner as instructed.
• Maintain work areas and equipment in the condition required by Legacy standards.
• Demonstrate proper body mechanics in all functions.
• Check the patient’s environment and equipment to ensure safety.
• Report safety concerns promptly to appropriate personnel.
• Follow Legacy’s exposure control plans for bloodborne and airborne pathogens.
• Demonstrate knowledge of techniques, procedures, and correct use of protective barrier equipment, including Universal Precautions.
• Assure a safe environment by instituting appropriate control measures.
• Attend annual education programs.
• Perform other duties as assigned.

Minimum Qualifications

• High School Diploma or GED, some medical knowledge

Required Years of Experience

• A minimum of 3-5 years of medical billing experience

Desirable Education and/or Experience

• Some training or background in ICD-A / CPT codes preferred

Required Knowledge, Skills, and/or Abilities

• Bilingual required
• Ability to understand and practice bookkeeping and accounting terminology required.
• Knowledge of medical terminology and billing practices preferred.
• Ability to operate computers and other office machines required.
• Must be able to take responsibility and work under pressure

About Legacy Community Health

Approachable & Collaborative — Leads with humility, values diverse perspectives, and builds trust through teamwork.

Driven & Committed — Takes initiative and goes the extra mile to improve patient outcomes and drive continuous improvement.

Thoughtful Communicators — Pairs clinical/technical skill with emotional intelligence, navigating complex situations with empathy and professionalism.