[Hiring] Senior Administrator - Appeals @Maximus

Role Description

Join our California Independent Medical Review (CA IMR) team as a Senior Administrator - Appeals, supporting the review and processing of workers' compensation appeal cases. In this fast-paced, production-driven role, you will:

• Analyze and enter medical case information.
• Review documentation for accuracy and completeness.
• Support the independent medical review process.

This fully remote position offers a flexible schedule, comprehensive training, company-provided equipment, and the opportunity to work with a collaborative team dedicated to helping employees succeed.

Qualifications

• 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.

Requirements

• 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.
• Follow established guidelines and directions while maintaining a proactive approach to meeting objectives and deadlines.
• Ability to work independently.

Benefits

• Work/Life Balance Support – Flexibility tailored to your needs!
• Comprehensive Insurance Coverage – Medical, Dental, Vision, Life insurance, and enjoy discounts on Auto, Home, Renter's, and Pet insurance.
• Future Planning – Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
• Paid Time Off Package – Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.
• Holistic Wellness Support – Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
• Recognition Platform – Acknowledge and appreciate outstanding employee contributions.
• Diversity, Equity, and Inclusion Initiatives – Join a workplace committed to fostering diversity and inclusion.
• Tuition Reimbursement – Invest in your ongoing education and development.
• Employee Perks and Discounts – Additional benefits and discounts exclusively for employees.
• Maximus Wellness Program and Resources – Access a range of wellness programs and resources tailored to your needs.
• Professional Development Opportunities – Participate in training programs, workshops, and conferences.