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Eligibility Analyst III - Remote

Date Posted: May 17, 2026
Yearly: USD - USD

Job Detail

  • location_on
    Location Phoenix, Arizona, United States of America
  • desktop_windows
    Job Type: Permanent
  • schedule
    Shift:
  • analytics
    Career Level:
  • group
    Positions:
  • calendar_view_day
    Experience:
  • male
    Gender: No Preference
  • school
    Degree:
  • calendar_month
    Apply Before: Jun 17, 2026

Job Description

Overview

The Eligibility Analyst III is a remote position focused on executing and supporting complex eligibility work. As a senior analyst, this role is responsible for ensuring eligibility accuracy and production stability, serving as escalation support for eligibility issues and driving quality in claim adjudication.

Key responsibilities

  • Accountable for the quality of eligibility driving claim adjudication
  • Responsible for data integrity of upstream client eligibility
  • Perform analysis and resolution of complex eligibility issues
  • Support root cause analysis for recurring eligibility defects
  • Serve as escalation support for Analyst I/II eligibility issues
  • Partner with teams during testing and production support
  • Maintain and enhance eligibility documentation and processing standards
  • Monitor production trends and identify areas for improvement
  • Ensure compliance with HIPAA and company standards
  • Identify opportunities for automation and process improvement

Required skills

  • Expert in EDI with understanding of eligibility data structures
  • Strong analytical and problem-solving skills
  • Ability to work independently on complex issues
  • Clear written and verbal communication
  • Familiarity with eligibility impacts on claims adjudication
  • Strong knowledge of transaction/file standards (270/271, 834, 835)
  • Ability to interpret and troubleshoot raw X12 files
  • Knowledge of data integration and ETL tools
  • Strong SQL and Excel skills
  • Experience with cloud data platforms (e.g., Snowflake, AWS, Azure)
  • Experience with workflow management systems (e.g., Zendesk, JIRA)

What the company offers

  • Medical, Dental, and Vision insurance
  • Disability and Life insurance
  • Employee Assistance Program
  • Remote work options
  • Generous Paid-Time Off
  • Annual Reviews and Development Plans
  • Retirement Plan with company match immediately 100% vested

Skills Required

Company Overview

Natchitoches, Louisiana, United States of America

Southern Scripts is a healthcare company focused on providing solutions in pharmaceutical management and cost-effective strategies. The company emphasizes strong client partnerships and the importance of delivering high-quality service in the healthc... Read More

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