Admin 2 - Appeals

Description & Requirements

Maximus is currently hiring for an Admin 2 - Appeals to join our QIC DME team.

The Admin 2 is responsible for various data entry tasks affiliated with the QIC DME program.

-This is a remote opportunity.



*Position is contingent upon contract award

*

Essential Duties and Responsibilities:
- Type/generate letters and other documents, as necessary.
- Assist in the preparation of reports.
- Create files in case management system.
- Update status of case in case management system.
- Fax and email file determination letters to interested parties.
- 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.
- Perform research into invoicing issues and perform outreach to health plans regarding any unpaid invoices.

- Perform quality checks of decisions letters to correct minor errors such as typos and grammer.

- Obtain appropriate information from various resources, such as internal/external references, medical and appeal professionals to generate decisions

- Create decision letters, in accordance with established policies and procedures, ensuring completeness and qualify of finished product

- Accurately update the workflow database(s)

- Provide administrative support to project

- Performs other duties as assigned by management

Minimum Requirements

- High School diploma, GED, or equivalent required.
- 2-4 years of experience required.

- Prior experience with Microsoft Office Suite preferred

- Prior experience with Medicare Appeals and Systems preferred

- Must be US Citizen or lived in US for last 5 years working 3 years continuously

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

Maximus is an equal opportunity employer.

We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.

Annual salary is just one component of Maximus's total compe...