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
...operations have been100% virtual , giving you a flexible and modern work environment. Requirements / Responsibilities / Rewards... ...What We Offer Work from Anywhere: Flexibility to work from home and create your ideal schedule. Comprehensive Training: Full training...
...Project (or other similar PPM software) and will be responsible for helping BD associates to learn and adopt these technologies. Bachelor's degree in related field (business, engineering, or related analytical field). Minimum of 6 years of project management. History of...
...Koniag Data Solutions, a Koniag Government Services company, is seeking a part-time Oracle Database Administrator with a Secret clearance to support KDS and our government customer in Kettering, OH. This is a part-time Remote opportunity. We offer competitive compensation...
...involves entering and updating information accurately while working from home. Its an easy task position, ideal for beginners or anyone looking... ...remote work. Responsibilities Enter data into online systems or spreadsheets Update and organize existing...
...Drywall Finisher Sinking Spring, PA Are you an experienced Drywall Finisher who loves producing flawless, high-end finishes? Join a respected team where your skill, precision, and pride in craftsmanship are valued every day. Why You'll Love Working with Us...