Remote Eligibility Verification Specialist

Maximus; Providence (RI); Remote; USD 19,000 - 26,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support the FEHB Protection Act Compliance and Verification Program for the U.S. Office of Personnel Management. This Admin II Operations role performs detailed reviews of enrollee-submitted documentation for FEHB eligibility.

This full-time, remote position requires residency within 75 miles of Lawrence, KS, and may be contingent upon contract award. Equipment will be provided to ensure secure processing of sensitive information.

Qualifications

• High School diploma or equivalent with 1-3 years of experience.
• Experience reviewing benefits, eligibility, insurance, or related docs against criteria.
• Strong attention to detail; ability to detect discrepancies and maintain case notes.
• Experience with electronic case records, document imaging, data entry, and workflow systems.
• Clear written and verbal communication; ability to conduct follow-up calls and explain documentation requirements.

Responsibilities

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

Skills

Attention to detail

Communication skills

Data entry

Discretion & confidentiality

Time management

Customer follow-up

Education

High School diploma or equivalent

Tools

Electronic case records

Document imaging

Workflow systems

Job description

Maximus is seeking an Eligibility Verification Specialist to support the FEHB Protection Act Compliance and Verification Program for the U.S. Office of Personnel Management. This Admin II Operations role performs detailed reviews of enrollee-submitted documentation for FEHB eligibility.

This full-time, remote position requires residency within 75 miles of Lawrence, KS, and may be contingent upon contract award. Equipment will be provided to ensure secure processing of sensitive information.