Eligibility Analyst I

MedImpact Healthcare Systems, Inc.

. Serve as a liaison between Account Management and the Eligibility Department .

Posted 11/11/2026full-timeSan Diego • California • United StatesJunior💰 $22 - $36 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in eligibility processing and data integrity, with a strong focus on quality assurance and compliance in healthcare environments. Proficient in data analysis and operational support, ensuring effective communication and problem-solving across departments.

Highest-signal resume keywords

Healthcare Eligibility ExperienceData Analysis ExperienceQuality Assurance ValidationMicrosoft Office SuitePharmscreens, EPSROI, and COB File Manager

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisQuality Assurance ValidationMathematical CalculationsFile ProcessingEligibility Record Remediation

Soft Skills

Problem SolvingEffective CommunicationAttention to Detail

Tools & Technologies

Microsoft Office SuitePharmscreensEPSROICOB File ManagerSecure FTP

Industry Keywords

Eligibility ProcessingData IntegrityComplianceSOX ComplianceOperational Support

About the role

Key responsibilities & impact

Serve as a liaison between Account Management and the Eligibility Department
Process daily client eligibility files
Perform quality assurance validation of eligibility file loads for data integrity, completeness, and processing compliance
Analyze and manually remediate eligibility record exceptions and data discrepancies
Coordinate with Account Management to validate file requirements and resolve processing issues
Research and perform cleanup activities related to eligibility and synchronization issues
Provide day-to-day operational production support and act as the eligibility Subject Matter Expert for strategic partners
Drive system enhancements for error-log handling, failed member-record reprocessing, automated file monitoring, and alerts with IT Data Exchange
Write and maintain reference documentation
Oversee verification of TPA and Commercial Carrier batch-file processing requests
Validate file delivery status or manually post files to secure FTP directories
Support performance guarantees, audits, and SOX compliance
No supervisory responsibilities

Requirements

What you’ll need

BS/BA and 1+ years’ experience or equivalent combination of education and experience
Intermediate to advanced knowledge of Microsoft Office Suite
Experience using Pharmscreens, EPSROI, and COB File Manager required following training
Data analysis experience preferred
Healthcare eligibility experience a plus
Ability to solve practical problems and deal with a variety of concrete variables
Ability to interpret written, oral, diagram, or schedule instructions
Ability to perform basic mathematical calculations and compute rates, ratios, and percentages
Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals
Ability to effectively present information in one-on-one and small group situations
Ability to work overtime, nights, weekends, or holidays as required
This position is not eligible for Sponsorship
Ability to sit, stand, walk, use hands, reach, and occasionally lift or move up to 25 pounds
Adequate close vision, color vision, and depth perception

Benefits

Comp & perks

Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401K with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
Remote work may be available with management approval based on business requirements