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
...religious community to ensure the patient's/loved ones spiritual and/or sacramental needs are being met.+ Coordinates spiritual/pastoral ministry and bereavement care for those approaching end of life and at death.+ Provides blessing/ritual/prayer for pastoral support upon...
...Lab Technician Tulsa, OK Job Type: Contract (4-6 months) Shifts: 24/7 Operation Rotating Schedule Week 1: Mon, Tue, Sat... ...contract with the possibility of becoming long-term. No prior experience is necessary, but a science background is preferred. The client...
...About Us: _ Established in 1963, Kubicki Draper is a beacon of legal expertise, offering trial, appellate, coverage, commercial, and... ...: _ Kubicki Draper's Miami office seeks an experienced Billing Clerk for the firm's busy accounting department. This position will...
Automotive Mobile Service TechnicianCompany: Apple Autos (Top Minnesota Workplace)Compensation: $23.00... ...Vision is to be Famous for Extraordinary Customer Experiences with People who are... ...service abilities, and the flexibility to work in a mobile environment. This role...
...smarter mobility worldwide, connecting cities as we reduce carbon and replace cars. Could you be the full-time hybrid Civil (Structural) Engineer in Pittsburgh, PA, US were looking for? Your future role Take on a new challenge and apply your civil and...