Coordinator 2 - Appeals QIC (remote)

2 months ago


Remote, United States Maximus Full time

General information

Job Posting Title Coordinator 2 - Appeals QIC (remote) Date Tuesday, July 2, 2024 City Remote Country United States Working time Full-time

Description & Requirements

Maximus QIC Appeals (Part A West) has an open position for a Coordinator 2. This is a remote, full-time position with flexible start and end times (8 hrs. per day) during core business hours.

Essential Duties and Responsibilities:

Function as a Subject Matter Expert in one or more process areas.

- Analyze data submitted for Independent Medical Review.

- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.

- Track and meet required deadlines for complex cases or other assigned tasks.

- Assist leadership through research of data and/or authoring reports.

- Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.

- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.

- Assist others or provide on-the-job training or act as a mentor to production staff.

- Prior experience with Microsoft Office Suite preferred

- Prior experience with Medicare Appeals and Systems preferred


Home Office Requirements:

- Hardwired internet (ethernet) connection

- Private work area and adequate power source

- All equipment will be provided by Maximus



Minimum Requirements

- High School Degree or equivalent required.

- 2-4 years of related professional experience required.



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