Senior Eligibility Analyst - Remote & Data Quality

Southern-Scripts-LLC; Dallas (TX); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Remote work options

Medical, dental, vision insurance

Disability and life insurance

Employee Assistance Program

Paid time off

Retirement plan with company match

Job summary

Southern Scripts is seeking an Eligibility Analyst III to join our remote team. You will drive complex eligibility work, ensure data integrity across multiple systems, and partner with EDI, implementation, and QA teams to support claims adjudication.

You will mentor junior analysts, handle escalation, and comply with HIPAA requirements while maintaining documentation and processing standards. Some travel may be required for onboarding and audits.

Qualifications

• Bachelor’s degree or equivalent experience.
• 5+ years in eligibility, EDI, or healthcare operations.
• Strong SQL & Excel skills.
• PBM or health plan experience preferred.
• Experience supporting production EDI and Eligibility environments.

Responsibilities

• Execute and support complex eligibility work with ownership.
• Quality backstop for eligibility accuracy and production stability.
• Analyze and resolve complex eligibility issues impacting claims and member benefits.
• Mentor Analyst I/II and provide escalation support.
• Collaborate with EDI, Implementation, Adjudication, and QA teams.
• Ensure HIPAA compliance and data integrity across systems.

Skills

EDI Expertise

Analytical thinking

Independent worker

Communication

Multi-tasking

Eligibility knowledge

Education

Bachelor’s degree or equivalent experience

Tools

EDI Standards

SQL

Excel

ETL tools

Snowflake

AWS/Azure

Zendesk

JIRA

Azure DevOps

Databases (Relational/NoSQL)

Job description

Southern Scripts is seeking an Eligibility Analyst III to join our remote team. You will drive complex eligibility work, ensure data integrity across multiple systems, and partner with EDI, implementation, and QA teams to support claims adjudication.

You will mentor junior analysts, handle escalation, and comply with HIPAA requirements while maintaining documentation and processing standards. Some travel may be required for onboarding and audits.