Maximus
Maximus
„Maximus“ padeda vyriausybinėms agentūroms įgyvendinti ir modernizuoti svarbias viešąsias programas sveikatos priežiūros, socialinių paslaugų, gynybos, nacionalinio saugumo ir civilinių paslaugų srityse. Įmonės veikla apima dirbtinį intelektą ir analitiką, debesijos sprendimus ir kibernetinį saugumą, skaitmenines platformas, kontaktų centrus, teisės gauti paslaugas nustatymo ir registracijos sistemas, klinikines paslaugas, „Medicaid“ sprendimus įmonėms, konsultavimą bei programų veiklos vykdymą. Federalinius, valstijų ir vietos valdžios klientus aptarnaujančios komandos derina technologijas su praktiniu paslaugų teikimu, kad pagerintų žmonių prieigą prie viešųjų paslaugų ir padėtų agentūroms pasiekti savo tikslus.

Senior Appeals Administrator – California Remote

Maximus is hiring a Senior Appeals Administrator to process California workers’ compensation medical review appeals remotely. The role involves analyzing healthcare records, maintaining case data, and supporting stakeholders throughout the appeals process.

Aprašymas

  • Stay current on project and corporate policies and procedures
  • Serve as a subject matter expert in one or more process areas
  • Review and analyze data submitted for Independent Medical Review
  • Gather and assess reports from treatment providers, facilities, participants, laboratories, and health plans
  • Record required information accurately in the case management system
  • Handle calls from clients, health plans, providers, and enrollees about case status, program questions, and the appeals process
  • Work within established guidelines while taking initiative to meet objectives and deadlines

Reikalavimai

  • Associate degree and at least two years of experience
  • A high school diploma or GED with at least four years of experience may substitute for an associate degree
  • At least two years of experience in healthcare, medical office administration, or a related field
  • Proficiency with computers and daily use of web-based applications
  • Strong analytical abilities
  • Detail-oriented and solution-focused approach
  • Excellent written and verbal communication skills
  • Knowledge of medical terminology
  • Experience accurately reviewing and processing medical records or other healthcare documentation
  • Ability to work independently
  • Private and secure workspace
  • Reliable high-speed internet with at least 20 Mbps download and 5 Mbps upload, or 50 Mbps download for shared connectivity

Privalumai

  • Flexible work schedule
  • Medical, dental, vision, and life insurance coverage
  • Discounts on auto, home, renters, and pet insurance
  • 401(k) retirement plan with company matching
  • Paid time off, holidays, and extended sick leave
  • Short- and long-term disability coverage
  • Employee Assistance Program offering physical, emotional, and financial wellness resources
  • Employee recognition platform
  • Diversity, equity, and inclusion initiatives
  • Tuition reimbursement
  • Employee discounts and perks
  • Maximus Wellness Program and related resources
  • Professional development through training, workshops, and conferences
  • Company-provided computer equipment
  • Comprehensive training
  • Private and secure workspace requirements
  • Reliable high-speed internet service

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