Medical Eligibility Specialist

Milwaukee, WI | Job ID: 57035

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Job Description

LaSalle Network is looking to hire Medical Eligibility Specialist. Candidates must perform the specific tasks required for the efficient and effective verification of eligibility and updating eligibility as required. These candidates must also have critical thinking ability to analyze and use sound judgment interacting with callers specific to providing accurate listings of contracted providers, verification of eligibility dates for a member, updating a Primary Care Physician when applicable, and/or re-directing a caller appropriately when unable to further assist the caller.

Minimum Requirements for the Medical Eligibility Specialist

  • Minimum High School Diploma
  • 1-2 years healthcare benefits, eligibility and claims experience
  • 1-2 years of prior authorization experience (preferred)
  • An active and valid Certified Pharmacy Technician license (preferred)
  • Computer literate
  • Problem solving and communication skills; verbal and written
  • Adequate knowledge of Healthcare/Managed Care Eligibility processes
  • Ability to work independently and resolve issues within a limited time frame

Medical Eligibility Specialist Responsibilities

  • Provide listings of contracted Primary Care Physicians and/or Specialists
  • Verify/confirm eligibility for a member
  • Update a Primary Care Physician within a member’s eligibility record
  • Clearly communicate verbally and/or in writing any updates needed outside of the skill set or access granted
  • Clearly hand-off callers to the appropriate call queue for further review/resolution
  • Track/document calls as appropriate

If this is something you are interested, and qualified, in please let me know as soon as possible. Thank you and I look forward to speaking with you soon!


Thank you, 

Bridget Gamel
Project Manager, Healthcare Revenue Cycle Solutions
LaSalle Network

LaSalle Network is an Equal Opportunity Employer, m/f/d/v.

LaSalle Network is Chicago's leading provider of professional staffing and recruiting services. Specializing in accounting and finance, marketing, executive search, technology, administrative, call center, and human resources, LaSalle serves companies of all sizes and across all industries. Since inception in 1998, LaSalle Network has served over 2,500 clients and placed over 25,000 candidates in temporary, temporary to permanent, and permanent positions.

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