Sr Admin - Appeals (Remote)

Description & Requirements

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 ...