Sr. Admin - Arbitration

Description & Requirements

Maximus is currently hiring for a Sr.

Admin - Arbitration to join our Georgia State Arbitration team.

This is a remote opportunity.

The Sr.

Admin - Arbitration will provide comprehensive administrative support to the New York IDR team.

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

This is a fast-paced, deadline-driven position.

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.

- 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.
- 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)

- Ability to successfully work in a fast-paced, deadline-driven environment

- 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 highly preferred

- Knowledge of CPT codes preferred

- Ability to commit to a training schedule of 8am - 5:30pm EST Monday - Friday preferred

Please note: For this position Maximus will provide equipment to use.

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 eithe...