Inbound Specialist (Remote near McAllen, TX)

Maximus is seeking an Eligibility Verification Specialist to support the U.S.

Office of Personnel Management's (OPM) FEHB Protection Act Compliance and Verification Program.

This CSR II position serves as a frontline customer service representative for Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Program enrollees, providing inbound telephone support for dependent eligibility verification.

The CSR II responds to questions regarding dependent eligibility verification requirements, acceptable documentation, submission deadlines, case status, and verification processes, and assists enrollees with Portal access, document submission, and navigation of program resources.

Remote Remote: Must reside within 50 miles of McAllen, TX location
Please note: This position is contingent upon contract award.

Essential Duties and Responsibilities:

- Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e.

telephone, emails, web chats, or written letters).

- Calls are predominantly routine, but may require deviation from standard screens, scripts, and procedures.

- Uses computerized system for tracking, information gathering, and/or troubleshooting.

- Provides feedback when needed, provide input on call trends, processes, procedures, and training.
- May respond to customer inquiries by referring them to published materials, secondary sources, or more senior staff.

- Provides inbound telephone support to enrollees on dependent eligibility verification requirements, acceptable documentation, deadlines, and case status.

- Assists callers with Portal access, login issues, and document upload using OPM-approved scripts and knowledge resources.

- Authenticates callers before sharing case information and protects PII and PHI in line with privacy and security requirements.

- Documents each interaction accurately in the OPM FEHB Protection Act Portal or other approved system of record.

- Escalates complex questions, reconsideration requests, language or accessibility needs, and potential fraud indicators per approved procedures.

- Meets attendance, schedule adherence, call quality, and documentation accuracy standards.

- High School diploma or equivalent with 6 months of customer service experience.

- May have additional training or education in area of specialization.

- - High School diploma or equivalent with 6 months of customer service experience required

- May have additional training or education in area of specialization.

- Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including completion of all Government-required background investigations, fingerprinting, credentialing, and security training requirements.

- Must be a U.S.

Citizen



*Position is contingent upon contract award

*

- This is a remote role.

Must reside within 50 miles of McAllen, TX location

- Equipment will be provided but must meet the remot...