Maximus

Essential Duties and Responsibilities:
- Investigate and respond to correspondence regarding the client Program.
- Investigate and respond to inquiries referred from Customer Service Representatives.
- Use MEDS for corrections to the beneficiaries enrollment/disenrollment form information.
- Assist in retroactively disenrolling beneficiaries who meet the client criteria.
- Perform Research for client on enrollments, disenrollments including EDER’s, Medical and Dental Exemptions, Waivers as requested.
- Contact beneficiaries by telephone and resolve enrollment/disenrollment problems.
- Locate enrollment forms, as necessary, in the mailroom or in the document library.
- Research review of the manual redaction of the managed care plan copies.
- Work Document Control Number (DCN) reports and make the necessary corrections.
- Interact with beneficiaries, plans, social services, and client.
- Process exemptions, waivers, and emergency disenrollment requests.
- Fax medical/dental exemption and waiver certificates to Doctors’ offices and facilities.
- Prep and batch exemptions, emergency disenrollments and waivers, for imaging.
- Prepare supporting documentation for final imaging.
- Keep filing current.
- Generate reports, as required, for supervisor and/or management.
- Meet production and quality goals and standards as defined in policy for the position.
- Maintain updated knowledge of the client Program including policies and procedures as referenced in the employee manual and other policies adopted by corporate, the project, and/or client as referenced in Desk Reference Procedures for Customer Service Representatives, Forms Processors, Enrollment Services, and Research Units and respond to inquiries in accordance with such policies and procedures.
- Maintain knowledge of contract compliance provisions of the project and exceeds those requirements for the position.
- Maintain knowledge of the client program Quality Manual for the department and position.
- Follow policies and procedures without deviation.
- Maintain a monthly QA audit score of 99% or better.
- Participate in training as identified by monitoring or quality audits.
- Meet all standards established for this position as outlined in the attached performance criteria.
- Provide backup to the call center and the forms processing function in Central Operations at minimum quality standards as specified for a Customer Service Representative and a Forms Processor level.
- Perform other duties as may be assigned by management.

- High school diploma or GED required and 6+ months of relevant professional experience required, or equivalent combination of education and experience.

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.

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.