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
...We are now hiring a full-time Physical Therapist to work in an Outpatient Orthopedic setting in Anchorage, AK. 40 hours per week are available... ...experience levels, including new grads. Full-time preferred. Part-time candidates with 16 hours of availability will be considered....
...Company in Brookwood, AL is looking for a Full-time OTR Class A Truck Driver. Most of our hauls are short local hauls where you are home... ...trailers, 4- 53ft dry vans, 1- 48ft flatbed, 1- 48ft stepdeck, 3 straight trucks, and a cargo van. Qualifications: At least High...
...Landscape Designer / Architect High-End Residential Design-Build | Licensure Track | $60k$100k+ | Relocation to Oklahoma City Scapes, Inc. Oklahoma City, OK Design-Build-Maintain | Estate-Level Residential Projects About the Role Scapes, Inc. designs...
...Pharmacy Technician - Home Infusion at Providence Non-RN - Oregon summary: The Pharmacy Technician - Home Infusion is responsible... ...strength lies in Our Promise of Know me, care for me, ease my way. Working at our family of organizations means that regardless of your...
...The Role: You will be responsible for : Handling inbound calls and emails in a professional manner. Resolving customer inquiries and requests and ensuring strong customer satisfaction. Working with various internal teams to ensure prompt and accurate order...