Eligibility Coordinator

LSMA Management Inc • San Bernardino, CA

7d

About The Position

The Eligibility Coordinator is responsible for the accurate, timely processing and maintenance of member eligibility data. This position supports daily eligibility operations – including file processing, data validation, member record updates, discrepancy resolution, and routine audits – to ensure data integrity and compliance with internal standards. The role provides essential operational support to internal departments that rely on precise eligibility information.

Requirements

• High school diploma or equivalent.
• 1+ year of managed care eligibility or healthcare administrative experience.
• Knowledge of eligibility and enrollment processes in healthcare or managed care.
• Understanding of demographics, plan assignments, PCP selections, and enrollment dates.
• Familiarity with HIPAA privacy requirements.
• Ability to identify discrepancies, missing data, or data-entry errors.
• Strong attention to detail and accuracy in data entry and documentation.
• Proficiency in Excel, Outlook, Word, Teams, and related tools.
• Strong written and verbal communication skills.
• Ability to interpret data across systems and documents.
• Ability to follow established procedures and processing standards.
• Ability to manage competing priorities and deadlines.
• Ability to work effectively within a team environment.
• Ability to learn new systems, workflows, and updates quickly.
• Ability to remain focused during periods of high volume or tight timelines.

Nice To Haves

• Associate’s degree or coursework in Healthcare Administration, Business, or related field.
• Experience in managed care, MSO, IPA, or health plan environments.
• Familiarity with eligibility systems and file formats (e.g. EX-CAP, rosters, 834 files).
• Understanding of Medi-Cal, Medicare, and commercial eligibility workflows

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED