Benefits Coordinator

LSMA Management IncSan Bernardino, CA
18h

About The Position

The Benefits Coordinator is responsible for setting up, maintaining, and auditing benefit plans within EZ-CAP to ensure accurate claims processing and compliance. This role translates contract benefit language into system rules, resolves discrepancies impacting claims adjudication, and supports monthly insurance file loads. The position requires strong attention to detail, problem-solving skills, and close collaboration with Eligibility, Claims, IT, and other internal teams.

Requirements

  • High school diploma or equivalent.
  • 1+ years of healthcare administration or managed care benefits experience.
  • Understanding benefit structures such as co-pays, coverage limits, visit caps, and exclusions.
  • General knowledge of Medi-Cal, Medicare, and commercial plan benefits.
  • Ability to read and interpret benefit information from contracts and plan documents.
  • Strong accuracy and attention to detail in data entry and documentation.
  • Ability to identify discrepancies and perform basic benefit audits.
  • Effective problem-solving and cross-functional communication skills.
  • Ability to prioritize workload and meet deadlines.
  • Professional communication skills, both written and verbal.
  • Ability to maintain confidentiality and follow HIPAA compliance.
  • Competence using spreadsheets and tracking tools for benefit updates.

Nice To Haves

  • Associate’s degree or coursework in Healthcare Administration, Business, or related field.
  • Experience in an MSO, IPA, or health plan
  • Familiarity with benefits interpretation systems (e.g. EZ-CAP).
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