Senior Coordinator - Appeals (Remote)

Description & Requirements

Maximus is hiring a Senior Coordinator - Appeals to support our Independent Medical Review (IMR) program.

In this role, you will help manage the Worker's Compensation appeals process, ensuring timely and accurate reviews.

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.

- Subject matter expert (SME) in preliminary review and document review.

- Assist leadership with training of new hire personnel

Minimum Requirements

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

- Proficient with preliminary and document review for California Independent Medical Review (IMR).

- Proficiency in Microsoft Office suite

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 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 challenging and rewarding career opportunities available for you.

A committed and diverse workforce is our most important resource.

Maximus is an Affirmative Action/Equal Opportunity Employer.

Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on var...