Job Description:
• Maintain updated knowledge of project and corporate policies and procedures
• 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
• Input necessary information into the system
• Respond to incoming calls from clients, health plans, providers, and enrollees regarding case status, program questions, and the appeals process
• Follow established guidelines and directions while proactively meeting objectives and deadlines
Requirements:
• Associate degree with 2+ years' experience
• Experience in lieu of an Associate degree: HS Diploma or GED and 4+ years of experience
• 2 years' experience in healthcare, medical office administration, or a related field
• Proficient in computer usage, including daily operation of web-based applications
• 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
• Ability to work independently
• Private and secure workspace
• Reliable high-speed internet service: minimum 20 Mbps download/50 Mbps for shared internet connectivity and 5 Mbps upload
Benefits:
• Flexible schedule
• Comprehensive medical, dental, vision, and life insurance
• Discounts on auto, home, renter's, and pet insurance
• 401K retirement savings plan with company matching
• Paid time off, holidays, and extended sick leave
• Short- and long-term disability coverage
• Employee Assistance Program supporting physical, emotional, and financial wellness
• Recognition platform
• Diversity, equity, and inclusion initiatives
• Tuition reimbursement
• Employee perks and discounts
• Maximus Wellness Program and resources
• Professional development opportunities, including training programs, workshops, and conferences
• Company-provided computer equipment
• Comprehensive training