Remote Eligibility Verification Specialist

Maximus; San Juan (PR); Remote; USD 19,000 - 26,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support the OPM FEHB Protection Act Compliance and Verification Program. This Admin II Operations position performs detailed reviews of enrollee-submitted documentation supporting dependent eligibility verification for the FEHB Program.

This is a full-time remote role with the requirement to reside within 75 miles of Lawrence, KS. Candidates must be a U.S.

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.
• Regular and predictable attendance is required.
• Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including background investigations.
• Must be able to pass a government background check.
• Must be a U.S. Citizen.

Responsibilities

• Review documents for completeness and accuracy against eligibility requirements.
• Compare records, identify missing or inconsistent information, and resolve routine discrepancies.
• Conduct outbound follow-up to request missing information 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 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

Document verification

Communication skills

Privacy & security

Education

High School diploma

Tools

Case management systems

Document imaging

Data entry

Job description

Maximus is seeking an Eligibility Verification Specialist to support the OPM FEHB Protection Act Compliance and Verification Program. This Admin II Operations position performs detailed reviews of enrollee-submitted documentation supporting dependent eligibility verification for the FEHB Program.

This is a full-time remote role with the requirement to reside within 75 miles of Lawrence, KS. Candidates must be a U.S.