Eligibility Verification & Admin Ops Specialist - Remote

Maximus; Dover (DE); Remote; USD 19,000 - 26,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB program compliance. This Admin II role requires reviewing enrollee documentation and maintaining accurate case records from a remote location within 75 miles of Lawrence, KS.

The position includes standard government background checks and eligibility verification duties. Responsibilities include document review, follow-ups, and meticulous data entry in case management systems to ensure compliance and processing accuracy.

Qualifications

• High School diploma or equivalent with 1-3 years of experience.
• Experience reviewing benefits, eligibility, insurance, or other supporting documentation against established criteria.
• Strong attention to detail and ability to compare records, recognize discrepancies, and maintain accurate case notes during repetitive document-review work.
• Experience with electronic case records, document imaging, data entry, and workflow or work-queue systems.
• Clear written and verbal communication skills, including experience conducting customer follow-up calls and explaining documentation requirements.
• Experience handling confidential information and following privacy, security, and records management procedures.
• Ability to follow structured procedures, manage assigned deadlines, learn program systems, and recognize when a case requires escalation.

Responsibilities

• Review supporting documents for completeness and accuracy against established eligibility requirements.
• Compare records, identify missing or inconsistent information, and resolve routine discrepancies using established procedures.
• Conduct outbound follow-up to request missing information, clarify documentation, and explain next steps.
• Maintain accurate case records, review notes, and status updates in designated systems.
• Manage assigned workloads and follow-up activities to meet quality, productivity, and processing standards.
• Escalate complex or unresolved cases through established channels.
• Protect confidential information and follow applicable privacy, security, and document-handling procedures.

Skills

Attention to detail

Data entry

Communication skills

Privacy and records management

Electronic case records

Confidential information handling

Follow structured procedures

Education

High School diploma or equivalent

Additional training/education in area of specialization

Tools

Case management systems

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB program compliance. This Admin II role requires reviewing enrollee documentation and maintaining accurate case records from a remote location within 75 miles of Lawrence, KS.

The position includes standard government background checks and eligibility verification duties. Responsibilities include document review, follow-ups, and meticulous data entry in case management systems to ensure compliance and processing accuracy.