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Sr Admin - Appeals

Maximus
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Maximus is currently hiring for a Sr. Admin-Appeals to support the Independent Medical Review (IMR) project. 

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 


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