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 ...
- Rate: 21.5
- Location: Las Cruces, US-NM
- Type: Permanent
- Industry: Finance
- Recruiter: Maximus
- Contact: Not Specified
- Email: to view click here
- Reference: 24412_NM_Las Cruces
- Posted: 2024-08-30 08:20:53 -
- View all Jobs from Maximus
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