Sr Admin - Appeals (Remote) - Maximus

Maximus is currently hiring for a Sr. Admin-Appeals to support the Independent Medical Review (IMR) program.

At Maximus, we are committed to cultivating a positive and inclusive work environment, and we are pleased to offer the following:

• Comprehensive Insurance Coverage - Medical, Dental, Vision, Life insurance, and enjoy discounts on Auto, Home, Renter's, and Pet insurance.

• Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.

• Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.

• Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).

• Recognition Platform - Acknowledge and appreciate outstanding employee contributions.

• Diversity, Equity, and Inclusion Initiatives - Join a workplace committed to fostering diversity and inclusion.

• Tuition Reimbursement - Invest in your ongoing education and development.

• Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.

• Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.

• Professional Development Opportunities: Participate in training programs, workshops, and conferences.

Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position

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

- Analyze data submitted for Independent Medical Review.

- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.

- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.

- 2 years experience in healthcare, medical office administration, or a related field.

- Strong analytical skills

- Detail and solution oriented

- Ability to work independently

- Excellent written and verbal communication

- Proficient in computer usage, including daily operation of web-based applications, email, and Microsoft Word

Minimum Requirements

- Associate degree with 2+ years' experience.

- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.

Preferred Skills
- High level of accuracy in reviewing documents

Home Office Requirements

- Maximus provides company-issued computer equipment

- Reliable high-speed internet service

- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

- Minimum 5 Mpbs upload speeds

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.

Hourly Base Pay Minimum for this Position

$

24.00

Hourly Base Pay Maximum for this Position

$

24.00