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
...As a Fire Sprinkler Inspector, you will play a crucial role in ensuring the safety and compliance of buildings and facilities by inspecting, testing, and maintaining fire protection systems. This position requires a strong understanding of fire codes, standards, and regulations...
...Kenosha Branch 12355 Uline Way, Kenosha, WI 53144 Ready to take your career to the next level? Uline seeks forward-thinking college graduates looking to make their mark on a growing company while learning from the best in the industry. This year-long program provides...
...Denver (APA) location is currently seeking both PT/FT Line Service Technician(s). Position entails fueling, towing and the servicing of... ...mobility and dexterity to utilize computer systems, fax machines, copiers, and other office.~Must possess: 1) ability to read and...
...Benefits: Supportive Space for Self-Employed Artists Flexible Independent Schedule Private Treatment Room We are a licensed... ...$50 per week Requirements: Licensed Permanent Makeup Artist or Tattoo Artist (per state/local regulations) Current...
Class A Class A Driver with Hazmat JobBaronTransport insists on hiring quality, professional drivers with proven driving records and the desire to... ...requirements:At least 23 years of ageA valid class "A" CDL with endorsements for hazardous materials and doubles are...