Appeals Coordinator

 

Job Description Summary:

Job Summary:

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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.
• This position may assist others or provide on-the-job training or act as a mentor to production staff.

Minimum Requirements:

• High School diploma or equivalent with 0-2 years of experience.

MAXIMUS Introduction: Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com. EEO Statement: 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 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 compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Posted Max: USD $24.04/Hr. Posted Min: USD $9.62/Hr.

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