Eligibility Data Lead — Hybrid Analytics & Data Quality

MaziCTools; United States; Hybrid; USD 30,073 - 35,638; Full time

Job summary

MaziCTools is seeking an Eligibility Specialist responsible for maintaining health plan membership and physician data. The role focuses on resolving eligibility issues, auditing data for accuracy, and assisting in analytical reporting.

Qualified candidates should have at least 1 year of related experience in healthcare eligibility and familiarity with managed care systems. The position offers a hybrid remote work model from Petaluma, CA.

Qualifications

• Minimum of 1 year of work experience related to healthcare eligibility.
• Knowledge of healthcare managed care policies and processes.
• Strong task management skills: organize, prioritize, and attention to detail.

Responsibilities

• Resolve eligibility issues and update member records in the database.
• Assist in processing monthly files from Health Plans and audit discrepancies.
• Conduct routine quality audits of eligibility uploads.

Skills

Healthcare/managed care eligibility

Microsoft Office Suite

Effective communication

Critical thinking

Customer service orientation

Education

High School Diploma

Tools

Medvision QuickCap 7

EZ-Cap

Epic-Tapestry

Job description

MaziCTools is seeking an Eligibility Specialist responsible for maintaining health plan membership and physician data. The role focuses on resolving eligibility issues, auditing data for accuracy, and assisting in analytical reporting.

Qualified candidates should have at least 1 year of related experience in healthcare eligibility and familiarity with managed care systems. The position offers a hybrid remote work model from Petaluma, CA.