Arbitration Admin - Appeals Part Time

Description & Requirements

Maximus is currently looking for an Part Time Administrator - Arbitration to join our State Arbitration team.

This is a remote opportunity.

The Arbitration - Admin will provide comprehensive administrative support to the State independent dispute resolution (IDR) team.

This role involves participation in daily operations, coordinating communications, and accurate data input to ensure the smooth functioning of the IDR process.



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* This is a part time remote position

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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.

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.

- Create arbitration cases in the system.

- Send requests for information to providers and health plans.

- Close arbitration cases in the system.

- Analyze data received from providers and health plans.

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

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

Minimum Requirements

- Associate degree with 2+ years' experience preferred.

- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of

experience) also considered.

- Strong organizational and multitasking abilities
- Excellent written and verbal communication skills

- Ability to work across multiple platforms

- Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)

- Experience with Salesforce platform highly preferred

- Attention to detail and accuracy

- Ability to work independently as a part of a team

- Familiarity with insurance documentation, explanation of benefits, and/or claim forms

required

- Knowledge of CPT codes preferred

- Must currently and permanently reside in the Continental US

Home Office Requirements:

- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet

connectivity (you can test this by going to www.speedtest.net)

- Minimum 5mpbs upload speed

- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to

the home router

- Private work area and adequate...