Medical Eligibility Specialist ~ 100 Openings!
Remote-US (MUST Reside Within 60 Miles of Dallas/Fort Worth)
REQUIRED QUALIFICATIONS
• High school diploma or GED required
• 1+ years' experience in specialty pharmacy, medical insurance, or healthcare setting
• Working knowledge of medical and pharmacy benefits, copay structures, and prior authorizations
• Familiarity with commercial and government payer systems preferred
• Strong communication, documentation, and negotiation skills
PREFERRED SKILLS
• Certificate in medical billing and coding
• Experience in medical collections or reimbursement support
• Knowledge of HIPAA, patient assistance programs (PAP), and appeals workflows
COMPENSATION & SCHEDULE
ROLE IMPACT
KEY RESPONSIBILITIES
• Conduct outbound calls to payers and gather missing insurance data for benefit investigations
• Submit and track prior authorizations, ensuring complete and timely insurer documentation
• Assist provider offices and patients with insurance forms and program applications
• Maintain ongoing communication with payers, pharmacies, and provider representatives
• Report reimbursement delays or trends and escalate issues when necessary
• Coordinate with internal departments and document all case activity accurately
• Address customer inquiries and resolve service requests with urgency and accuracy
• Ensure all prior authorization materials meet compliance, including NPI, referrals, and patient demographics
• Identify and report adverse events (AEs) per SOP and training standards
CORE TOOLS & SYSTEMS
• Microsoft Excel, Outlook, Word
• Insurance portals and EMR systems
• Document and case management platforms
• Phone systems and CRM/call tracking
LEGAL NOTICE
By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at:
#ARLINGTON123
...professional development opportunities. For more detailed information, please visit our benefits page at SCBenefits . Performs firefighting work in the protection of life and property by combating, extinguishing fires under emergency conditions which involves personal...
...opportunity, please send me updated resume. Thanks Job Title ArcGIS Analyst with Arc Py, JavaScript/TypeScript, HTML5, CSS3, and ESRI JavaScript API Location- Exton PA ( Remote Work ) Duration 12+ Months Contracts Highly Chance to Extend...
Vivian Concierge is seeking a Social Work Social Worker for a job in Clarksville, TN 37040, Tennessee. Job Description & Requirements Specialty: Social Worker Discipline: Social Work Employment Type: Staff Make an Impact: Social Worker, Psych RN, or Licensed...
...Join Our Team as a Senior Test Engineer (Devices) Drive Innovation, Ensure Safety, Elevate Quality Are you a passionate, highly technical Software Development Engineer in Test (SDET) with a knack for automation and a desire to make a meaningful impact in medical...
...Job Summary: The EHS Specialist Intern will support the Environmental, Health, and Safety (EHS) team by assisting with the completion of the company-wide annual Job Safety Analysis (JSA) and Personal Protective Equipment (PPE) Assessments. This role involves observing...