Coordinator 2 - Appeals - Maximus

Maximus is seeking a Coordinator 2 Appeals. This is a fully remote position.

Essential Duties and Responsibilities:

Function as a Subject Matter Expert in one or more process areas.

- Analyze data submitted for Independent Medical Review.

- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.

- Track and meet required deadlines for complex cases or other assigned tasks.

- Assist leadership through research of data and/or authoring reports.

- Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.

- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.

- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.

- Assist others or provide on-the-job training or act as a mentor to production staff.

Job Description:

- Function as a Subject Matter Expert in one or more process areas.

- Analyze data submitted for Independent Medical Review.

- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.

- Track and meet required deadlines for complex cases or other assigned tasks.

- Assist leadership through research of data and/or authoring reports.

- Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.

- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.

- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.

- This position may assist others or provide on-the-job training or act as a mentor to production staff.

Minimum Requirements:

- High School diploma or equivalent with 0-2 years of experience.

Home Office Requirements:

-Hardwired internet (ethernet) connection.

-Internet download speed of 25mbps single upload or higher required (you can test this by going to www.speedtst.net).

-Private work area and adequate power source.

-Video calls may be requested on occasion. Proper background and attire is required.

Minimum Requirements

Minimum Requirements:
- High School Degree or equivalent required.

- 2-4 years of related professional experience required.

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.