Team Leader - Appeals - Maximus

Maximus is seeking a Team Leader - Appeals to support our FED NSA IDR (Federal No Surprises Act Independent Dispute Resolution) program.

*This is a fully remote, full-time role*

Essential Duties and Responsibilities:
- Front-line contact for issues identified by agents, including but not limited to: complex escalated issues, unit concerns such as workload distribution/prioritizing, coordination between different project functional areas and ensuring.
- Provide supervisory support to supervisor on an as needed basis to ensure efficient production levels in the unit.
- Assist the Supervisor in handling escalated calls from members and providers.
- Process informal dispute resolution (IDR), appeals and complaints for enrollment and eligibility for health coverage.
- Schedule Appeal Hearings utilizing approved client schedules.
- Review, assess and processes requests for backdating of enrollment.
- Liaison between supervisors and agents to resolve escalated issues or to provide feedback on unnecessary/inappropriate escalations to ensure proper cross-training is happening.
- Assign and follow up on daily workload items to agents to ensure SLA compliance and to maintain a distributed workload.

- Assist the supervisor in guiding and supporting the eligibility review team to ensure high performance and adherence to program policies

- Aid in the eligibility review process, ensuring that reviews are processed accurately and in a timely manner

- Help resolve complex eligibility cases and provide input on final eligibility determinations as needed

- Participate in audits of the eligibility review process to identify and address any discrepancies or areas for improvement

Home Office Requirements:

- Maximus provides company-issued computer equipment

- Reliable high-speed internet service

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

- Minimum 5 MBPS upload speeds

- Private and secure workspace

Minimum Requirements

- Associate degree with 4+ years experience.
- Equivalent combination of education and experience (High School diploma or equivalent with 6+ years experience) also considered.

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

$

36,800.00

Hourly Base Pay Maximum for this Position

$

45,000.00