Sr Coordinator - Appeals

Description & Requirements

Maximus is currently hiring for a Sr.

Coordinator - Appeals to join our Fed NSA team.

This is a remote opportunity.

The Sr.

Coordinator - Appeals is responsible for reviewing payment determinations from the initiating party.

The Sr.

Coordinator must logically analyze information and apply various factors to an ultimate decision and final payment determination.

Impartiality in review is essential.

Essential Duties and Responsibilities:

- Assist leadership through research of data and/or authoring reports.

- Analyze data using all applicable law regulations (state and/or government process documents, and other sources as defined by the client contract.

- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtain advice where precedents are unclear or not available from the client.

- Respond to the needs of outside contacts, including but not limited to: Client, injured workers, injured worker's representatives, claims administrators, providers, etc.

- Answer and respond to phone calls/emails within defined timeframes.

- Identify the need for process changes and documentation updates and/or development.

- Create, maintain, and update documentation when appropriate in accordance with document control process.

Minimum Requirements

- High school diploma or GED required and 4+ years of relevant professional experience required, or equivalent combination of education and experience.

- Experience in a healthcare setting and/or with appeals and claims required

- Prior Fed NSA experience preferred

- Ability to commit to a training schedule of 8:30am - 5:00pm EST Monday - Friday required

- Ability to work a schedule between the hours of 7:00am - 6:30pm EST Monday - Friday required

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 either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router

- Private work area and adequate power source

- Must currently and permanently reside in the Continental US

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 c...