Medical Eligibility Specialist

5 days ago


Dallas, Texas, United States CornerStone Staffing Full time
Job Summary

We are seeking a highly skilled Medical Eligibility Specialist to join our team at CornerStone Staffing. As a Medical Eligibility Specialist, you will play a critical role in ensuring that plan members meet plan eligibility requirements to receive medication(s).

Key Responsibilities
  • Coordinate access to alternate funding programs and provide assistance to members and physician staff to complete all necessary financial assistance program forms
  • Maintain a regular cadence of communication with members, physician offices, and financial assistance programs to manage the status of each member
  • Verify pharmaceuticals/prescriptions dispenses to members
  • Resolve inbound calls from members, physicians, and programs as necessary
  • Utilize Salesforce to accurately document/record all interactions with members, health care providers, pharmacies, and financial assistance entities
  • Ensure compliance with all relevant laws and regulations
  • Collaborate with cross-functional teams to achieve business objectives
  • Develop and maintain relationships with key stakeholders
  • Stay up-to-date with industry trends and best practices
  • Participate in ongoing training and professional development
  • Perform other duties as assigned
Requirements
  • Minimum 2+ years medical office assistant, specialty/infusion pharmacy intake, or healthcare reimbursement experience
  • 2+ years customer service experience in a health care or health insurance environment
  • College degree preferred
  • Spanish Bilingual preferred
  • Strong communication and interpersonal skills
  • Ability to work in a fast-paced environment
  • Proficiency in Salesforce
  • Strong analytical and problem-solving skills
  • Ability to maintain confidentiality and handle sensitive information
  • Flexibility to work varying shifts
What We Offer
  • Competitive salary and benefits package
  • Opportunities for professional growth and development
  • Collaborative and dynamic work environment
  • Recognition and rewards for outstanding performance
  • Comprehensive training and support
  • Flexible scheduling and work-life balance

We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity.



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