Senior Administrator - Appeals (Remote)

Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position

- Function as a Subject Matter Expert in one or more process areas.

- Analyze data submitted for Independent Medical Review.

- 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.

- Follows established guidelines and directions while maintaining a proactive approach to meeting objectives and deadlines

- Ability to work independently

Minimum Requirements

- Associate degree with 2+ years' experience.

- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.

- Proficient in computer usage, including daily operation of web-based applications

- 2 years experience in healthcare, medical office administration, or a related field.

Preferred Skills

- Strong analytical skills

- Detail and solution oriented

- Excellent written and verbal communication

- Knowledge of medical terminology

- Experience reviewing and processing medical records or other healthcare documentation with a high degree of accuracy and attention to detail.

- Follows established guidelines and directions while maintaining a proactive approach to meeting objectives and deadlines

Home Office Requirements

- Maximus provides company-issued computer equipment

- Private and secure workspace

- Reliable high-speed internet service



* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity



* Minimum 5 Mpbs upload speeds

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 compensation package.

Other rewards may include short- and long-term incentives as well as program-specific awards.

Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off.

Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience.

An applicant's salary history will not be used in determining ...