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Company Overview: Hyatt Regency Green Bay is seeking an experienced Housekeeping Supervisor to help lead our Housekeeping team.
Did you know we are located in the in the heart of downtown and home of the Green Bay Packers? The hotel is minutes away from major sporting events, cultural activities, entertainment, museums, and attractions.
We are the largest, full-service hotel in the market with 243 all-suite guest rooms and 80,000 square feet of space.
We believe our guests select Hyatt because of our caring and attentive colleagues who are focused on providing meaningful connections and memorable experiences.
We are looking for a dynamic leader to join our fun, creative and innovative team.
Position Summary: The Housekeeping Supervisor is responsible for supervisory duties in the Housekeeping department, including but not limited to inspecting guest rooms, counseling and interviewing colleagues, resolving guest complaints, and general office duties.
Detailed Description: Must ensure guests are consistently served with exceptional service and experiences.
Assist with analyzing, investigating, and resolving all guest complaints regarding cleanliness of rooms.
Consistently perform inspections and maintain safety and cleanliness of guest rooms, public space and heart-of-house areas.
Consistently assist with evaluating condition furniture, fixtures, décor, etc.
Supervise, empower, lead, coach and motivate the team towards achieving exceptional cleanliness and guest service, as well as colleague satisfaction results.
Provide clear direction in assigning and instructing colleagues in details of work.
Plan, organize, and monitor staff activities to ensure compliance with quality assurance standards set by hotel.
Assist with ensuring proper usage of chemicals and cleaning supplies.
Assist with ensuring proper labeling of hazardous supplies in accordance with hotel hazard communication program.
Assist with planning and conducting colleague monthly department meetings.
Attend various hotel leader related meetings to obtain and disseminate pertinent information.
Abide by all organizational policies and procedures.
Core Competencies: Action oriented - Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
Drives engagement - Creating a climate where people are motivated to do their best to help the organization achieve its objectives.
Communicates effectively - Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
Qualifications: Minimum of 1-year hotel experience, prior supervisory experience preferred Demonstrated ability to effectively interact with people of diverse socioeconomic, cultural, disability, and ethnic backgrounds Clear concise written and verbal communication skills in English, and Spanish preferred.
Must be proficient in Microsoft Word and Excel Must have excellent organizational, interpersonal and administrative ski...
....Read more...
Type: Permanent Location: Green Bay, US-WI
Salary / Rate: Not Specified
Posted: 2026-08-19 10:08:07
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Essential Duties and Responsibilities:
- Answer incoming customer inquiries received via telephone, Interactive Voice Response (IVR), web chat functions, or other approved contact channels in accordance with performance standards, policies, procedures, and confidentiality and privacy requirements.
- Provide accurate information regarding programs and services to consumers, prospective enrollees, individuals acting on behalf of enrollees, health plans, and providers.
- Track, document, and record all customer interactions, inquiries, complaints, comments, actions taken, and transactions in applicable systems.
- Complete associated tasks and transactions according to established guidelines to ensure accuracy and completeness.
- Navigate multiple computer systems while interacting with customers and perform data entry accurately.
- Facilitate fulfillment of customer requests for materials via mail, email, or electronic delivery as appropriate.
- Transfer or refer customers to appropriate internal or external entities in accordance with established guidelines.
- Address customer inquiries and resolve routine issues to ensure appropriate actions or updates are completed.
- Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation or resolution as needed.
- Facilitate translation or interpretation services for non English speaking customers according to procedures.
- Communicate with supervisors regarding potential needs, concerns, or issues impacting service delivery.
- Meet Quality Assurance (QA), productivity, and other key performance metrics.
- Attend required meetings and trainings and maintain up to date knowledge of all programs, systems, policies, and procedures.
- Perform other related duties as assigned by management.
Minimum Requirements
- High school diploma or GED required and 0-6 months of relevant professional experience required, or equivalent combination of education and experience.
- Availability to work shifts between 8:00am and 6:30pm CST (7am and 5:30pm MST)
- Ability to type efficiently
- Continuously demonstrate a high sense of urgency and perform under pressure
- Excellent Attendance (no time off during training)
- Organization and work prioritization skills
- Basic computer aptitude in Windows and/or Mac
- Ability to handle 100+ calls a day, handle multiple repetitive calls
Day 1 requirements:
- Must be able to work onsite on Day 1 for equipment training
- Must be able to complete classroom and on-the-job training with no time missed.
- Must be willing and able to work with webcam on during training and other meetings as instructed by management
Home Office Requirements:
- A quiet, professional work-space free from distractions and background noise
- A workspace large enough to hold 2 large monitors, laptop, keyboard, mouse and docking station.
Equipment is provided.
- Reliable, high-speed internet service, must be a traditional, wired high-speed connec...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:08:07
-
Essential Duties and Responsibilities:
- Answer incoming customer inquiries received via telephone, Interactive Voice Response (IVR), web chat functions, or other approved contact channels in accordance with performance standards, policies, procedures, and confidentiality and privacy requirements.
- Provide accurate information regarding programs and services to consumers, prospective enrollees, individuals acting on behalf of enrollees, health plans, and providers.
- Track, document, and record all customer interactions, inquiries, complaints, comments, actions taken, and transactions in applicable systems.
- Complete associated tasks and transactions according to established guidelines to ensure accuracy and completeness.
- Navigate multiple computer systems while interacting with customers and perform data entry accurately.
- Facilitate fulfillment of customer requests for materials via mail, email, or electronic delivery as appropriate.
- Transfer or refer customers to appropriate internal or external entities in accordance with established guidelines.
- Address customer inquiries and resolve routine issues to ensure appropriate actions or updates are completed.
- Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation or resolution as needed.
- Facilitate translation or interpretation services for non English speaking customers according to procedures.
- Communicate with supervisors regarding potential needs, concerns, or issues impacting service delivery.
- Meet Quality Assurance (QA), productivity, and other key performance metrics.
- Attend required meetings and trainings and maintain up to date knowledge of all programs, systems, policies, and procedures.
- Perform other related duties as assigned by management.
Minimum Requirements
- High school diploma or GED required and 0-6 months of relevant professional experience required, or equivalent combination of education and experience.
- Must be fluent in English and specified secondary language.
Job Requirements:
- Must be fluent in both Spanish and English
- Availability to work shifts between 8:00am and 6:30pm CST (7am and 5:30pm MST)
- Ability to type efficiently
- Continuously demonstrate a high sense of urgency and perform under pressure
- Excellent Attendance (no time off during training)
- Organization and work prioritization skills
- Basic computer aptitude in Windows and/or Mac
- Ability to handle 100+ calls a day, handle multiple repetitive calls
- Bilingual candidates must pass a bilingual assessment
Day 1 requirements:
- Must be able to work onsite on Day 1 for equipment training
- Must be able to complete classroom and on-the-job training with no time missed.
- Must be willing and able to work with webcam on during training and other meetings as instructed by management
Home Office Requirements:
- A quiet, professional work-space free from distractions and background noise
- A workspace large en...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:08:03
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Essential Duties and Responsibilities:
- Answer incoming customer inquiries received via telephone, Interactive Voice Response (IVR), web chat functions, or other approved contact channels in accordance with performance standards, policies, procedures, and confidentiality and privacy requirements.
- Provide accurate information regarding programs and services to consumers, prospective enrollees, individuals acting on behalf of enrollees, health plans, and providers.
- Track, document, and record all customer interactions, inquiries, complaints, comments, actions taken, and transactions in applicable systems.
- Complete associated tasks and transactions according to established guidelines to ensure accuracy and completeness.
- Navigate multiple computer systems while interacting with customers and perform data entry accurately.
- Facilitate fulfillment of customer requests for materials via mail, email, or electronic delivery as appropriate.
- Transfer or refer customers to appropriate internal or external entities in accordance with established guidelines.
- Address customer inquiries and resolve routine issues to ensure appropriate actions or updates are completed.
- Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation or resolution as needed.
- Facilitate translation or interpretation services for non English speaking customers according to procedures.
- Communicate with supervisors regarding potential needs, concerns, or issues impacting service delivery.
- Meet Quality Assurance (QA), productivity, and other key performance metrics.
- Attend required meetings and trainings and maintain up to date knowledge of all programs, systems, policies, and procedures.
- Perform other related duties as assigned by management.
Minimum Requirements
- High school diploma or GED required and 0-6 months of relevant professional experience required, or equivalent combination of education and experience.
- Must be fluent in English and specified secondary language.
Job Requirements:
- Must be fluent in both Spanish and English
- Availability to work shifts between 8:00am and 6:30pm CST (7am and 5:30pm MST)
- Ability to type efficiently
- Continuously demonstrate a high sense of urgency and perform under pressure
- Excellent Attendance (no time off during training)
- Organization and work prioritization skills
- Basic computer aptitude in Windows and/or Mac
- Ability to handle 100+ calls a day, handle multiple repetitive calls
- Bilingual candidates must pass a bilingual assessment
Day 1 requirements:
- Must be able to work onsite on Day 1 for equipment training
- Must be able to complete classroom and on-the-job training with no time missed.
- Must be willing and able to work with webcam on during training and other meetings as instructed by management
Home Office Requirements:
- A quiet, professional work-space free from distractions and background noise
- A workspace large en...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:08:00
-
Essential Duties and Responsibilities:
- Answer incoming customer inquiries received via telephone, Interactive Voice Response (IVR), web chat functions, or other approved contact channels in accordance with performance standards, policies, procedures, and confidentiality and privacy requirements.
- Provide accurate information regarding programs and services to consumers, prospective enrollees, individuals acting on behalf of enrollees, health plans, and providers.
- Track, document, and record all customer interactions, inquiries, complaints, comments, actions taken, and transactions in applicable systems.
- Complete associated tasks and transactions according to established guidelines to ensure accuracy and completeness.
- Navigate multiple computer systems while interacting with customers and perform data entry accurately.
- Facilitate fulfillment of customer requests for materials via mail, email, or electronic delivery as appropriate.
- Transfer or refer customers to appropriate internal or external entities in accordance with established guidelines.
- Address customer inquiries and resolve routine issues to ensure appropriate actions or updates are completed.
- Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation or resolution as needed.
- Facilitate translation or interpretation services for non English speaking customers according to procedures.
- Communicate with supervisors regarding potential needs, concerns, or issues impacting service delivery.
- Meet Quality Assurance (QA), productivity, and other key performance metrics.
- Attend required meetings and trainings and maintain up to date knowledge of all programs, systems, policies, and procedures.
- Perform other related duties as assigned by management.
Minimum Requirements
- High school diploma or GED required and 0-6 months of relevant professional experience required, or equivalent combination of education and experience.
- Must be fluent in English and specified secondary language.
Job Requirements:
- Must be fluent in both Spanish and English
- Availability to work shifts between 8:00am and 6:30pm CST (7am and 5:30pm MST)
- Ability to type efficiently
- Continuously demonstrate a high sense of urgency and perform under pressure
- Excellent Attendance (no time off during training)
- Organization and work prioritization skills
- Basic computer aptitude in Windows and/or Mac
- Ability to handle 100+ calls a day, handle multiple repetitive calls
- Bilingual candidates must pass a bilingual assessment
Day 1 requirements:
- Must be able to work onsite on Day 1 for equipment training
- Must be able to complete classroom and on-the-job training with no time missed.
- Must be willing and able to work with webcam on during training and other meetings as instructed by management
Home Office Requirements:
- A quiet, professional work-space free from distractions and background noise
- A workspace large en...
....Read more...
Type: Permanent Location: Austin, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:08:00
-
Essential Duties and Responsibilities:
- Answer incoming customer inquiries received via telephone, Interactive Voice Response (IVR), web chat functions, or other approved contact channels in accordance with performance standards, policies, procedures, and confidentiality and privacy requirements.
- Provide accurate information regarding programs and services to consumers, prospective enrollees, individuals acting on behalf of enrollees, health plans, and providers.
- Track, document, and record all customer interactions, inquiries, complaints, comments, actions taken, and transactions in applicable systems.
- Complete associated tasks and transactions according to established guidelines to ensure accuracy and completeness.
- Navigate multiple computer systems while interacting with customers and perform data entry accurately.
- Facilitate fulfillment of customer requests for materials via mail, email, or electronic delivery as appropriate.
- Transfer or refer customers to appropriate internal or external entities in accordance with established guidelines.
- Address customer inquiries and resolve routine issues to ensure appropriate actions or updates are completed.
- Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation or resolution as needed.
- Facilitate translation or interpretation services for non English speaking customers according to procedures.
- Communicate with supervisors regarding potential needs, concerns, or issues impacting service delivery.
- Meet Quality Assurance (QA), productivity, and other key performance metrics.
- Attend required meetings and trainings and maintain up to date knowledge of all programs, systems, policies, and procedures.
- Perform other related duties as assigned by management.
Minimum Requirements
- High school diploma or GED required and 0-6 months of relevant professional experience required, or equivalent combination of education and experience.
- Availability to work shifts between 8:00am and 6:30pm CST
- Ability to type efficiently
- Continuously demonstrate a high sense of urgency and perform under pressure
- Excellent Attendance (no time off during training)
- Organization and work prioritization skills
- Basic computer aptitude in Windows and/or Mac
- Ability to handle 100+ calls a day, handle multiple repetitive calls
Day 1 requirements:
- Must be able to work onsite on Day 1 for equipment training
- Must be able to complete classroom and on-the-job training with no time missed.
- Must be willing and able to work with webcam on during training and other meetings as instructed by management
Home Office Requirements:
- A quiet, professional work-space free from distractions and background noise
- A workspace large enough to hold 2 large monitors, laptop, keyboard, mouse and docking station.
Equipment is provided.
- Reliable, high-speed internet service, must be a traditional, wired high-speed connection such as cable or...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:58
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Milwaukee, US-WI
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:55
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:52
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:50
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Eau Claire, US-WI
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:46
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:43
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:42
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Charleston, US-WV
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:42
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Morgantown, US-WV
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:41
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:40
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Spokane, US-WA
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:36
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:33
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:33
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:32
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:31
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:27
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:25
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:21
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:18
-
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, 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 obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Review and interpret Explanation of Benefits (EOBs), HCFA/CMS-1500 claim forms, UB-04 forms, and other healthcare-related documentation.
- Analyze eligibility information and make accurate eligibility determinations based on applicable guidelines, regulations, and case-specific facts.
- Identify discrepancies, inconsistencies, and missing information across multiple sources of documentation.
- Research and evaluate complex cases that require independent judgment and problem-solving.
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Strong knowledge of healthcare claims processing, including EOBs, HCFA/CMS-1500 claim forms, and related billing documentation.
- Demonstrated ability to make eligibility determinations using critical analysis and independent judgment.
- Strong analytical and investigative skills with the ability to connect information from multiple sources.
- Ability to think beyond linear processes and navigate complex scenarios where information may be incomplete or conflicting.
- Excellent attention to detail, organizational skills, and decision-making abilities.
- Ability to work a schedule between the hours of 8:00am - 5:30pm EST Monday - Friday required.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 25mbps 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 Category 5 or 6 ethernet patch cable to the home router
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportu...
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Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2026-08-19 10:07:17
