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
.../ 2 days remote) We are looking for a talented Quantitative Model Engineer to join our dynamic transaction surveillance team. This... ...but exceed regulatory expectations. Translate quantitative experience into algorithms with high accuracy to detect suspicious trading...
...About the Role: Revature helps motivated individuals kick start a career in tech. With our Entry Level Software Developer role, there is no prior professional experience required. Our employees are well-prepared with effective, proven, on-the-job training across all...
...GARNEY CONSTRUCTION An Organizational Development Manager position is available at Garney construction in Kansas City, MO . The Organizational Development Manager will be responsible for enhancing the overall effectiveness, agility, and health of the organization...
Preferred handling shipping and packaging experience and internet skills.
**** **Nurse Practitioner / Physician Assistant - Outpatient Dementia Neurology** Weston, FL Full-Time | Monday-Friday | No Weekends |... ...passionate about cognitive disorders and providing patient-centered care? Join our dedicated outpatient neurology team, where you'll...