Remote Eligibility Verification Specialist

Maximus; Lawrence (KS); Remote; USD 19,000 - 26,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB compliance and verification. This Admin II Operations role conducts detailed reviews of enrollee documentation for FEHB eligibility and ensures accuracy in case records.

Remote work is available within 75 miles of Lawrence, KS, with equipment provided. Responsibilities include reviewing documents, following up on missing information, and maintaining confidential data while adhering to privacy and security procedures.

Qualifications

• High School diploma or equivalent with 1-3 years of experience.
• Experience reviewing benefits, eligibility, insurance, or other supporting documentation against established criteria.
• 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.
• Regular and predictable attendance is required.
• Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including completion of all Government-required background investigations, fingerprinting, credentialing, and security training requirements.
• Must be able to pass a government background check
• Must be a U.S. Citizen
• Position is contingent upon contract award

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

Written communication

Confidential handling

Structured procedures

Education

High School diploma or equivalent

Tools

Electronic case records

Document imaging

Data entry

Workflow systems

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB compliance and verification. This Admin II Operations role conducts detailed reviews of enrollee documentation for FEHB eligibility and ensures accuracy in case records.

Remote work is available within 75 miles of Lawrence, KS, with equipment provided. Responsibilities include reviewing documents, following up on missing information, and maintaining confidential data while adhering to privacy and security procedures.