Data Integrity & Eligibility Specialist

Personify Health

5 days ago

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Personify Health seeks a data integrity-focused analyst to validate and maintain member eligibility data across our benefits platform.

You will analyze files, standardize data (including 834 layouts), run quarterly censuses, and work with clients and vendors to resolve issues.

Strong Excel skills and basic SQL are preferred, with 1–2 years of experience using health-data systems.

High school diploma or equivalent.
Some post-secondary education preferred.
1–2 years of experience with Eldorado (HealthPac), QikLink, or GAIS systems preferred.

Analyze and validate eligibility files: Review raw data and flat files, run pre-load analysis to verify accuracy, and identify data issues before they reach downstream systems.
Standardize and transform data: Combine raw information from diverse sources into consistent, readable formats — including 834 file layouts — and submit eligibility and coverage data to downstream vendors.
Run quarterly and monthly censuses: Execute quarterly audits to catch issues such as invalid pends, overage dependents, invalid departments, rating structure and billing tier mismatches, ID card format errors, and life volume discrepancies; run monthly per-client censuses on cut-off dates to validate certs and departments.
Build and improve eligibility processes: Assist in designing, programming, testing, and standardizing procedures for eligibility file processing and data management.
Communicate with clients and vendors: Coordinate directly with external vendors and clients on eligibility data questions, file issues, and resolution timelines.