Remote Eligibility Verification Specialist (FEHB/PSHB)

Maximus; Atlanta (GA); Remote; USD 20,000 - 28,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB enrollment verification for the OPM program. This CSR II role acts as a frontline customer service representative handling inbound inquiries on dependent eligibility verification, documentation, deadlines, case status, and Portal access.

The position is remote but requires residence within 50 miles of McAllen, TX; work is contingent on contract award.

Qualifications

• High School diploma or equivalent with 6 months of customer service experience.
• 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 a U.S. Citizen

Responsibilities

• Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters).
• Calls are predominantly routine, but may require deviation from standard screens, scripts, and procedures.
• Uses computerized system for tracking, information gathering, and/or troubleshooting.
• Provides feedback when needed, provide input on call trends, processes, procedures, and training.
• May respond to customer inquiries by referring them to published materials, secondary sources, or more senior staff.
• - Provides inbound telephone support to enrollees on dependent eligibility verification requirements, acceptable documentation, deadlines, and case status.
• Assists callers with Portal access, login issues, and document upload using OPM-approved scripts and knowledge resources.
• Authenticates callers before sharing case information and protects PII and PHI in line with privacy and security requirements.
• Documents each interaction accurately in the OPM FEHB Protection Act Portal or other approved system of record.
• Escalates complex questions, reconsideration requests, language or accessibility needs, and potential fraud indicators per approved procedures.
• Meets attendance, schedule adherence, call quality, and documentation accuracy standards.

Education

High School diploma or equivalent with 6 months of customer service experience

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB enrollment verification for the OPM program. This CSR II role acts as a frontline customer service representative handling inbound inquiries on dependent eligibility verification, documentation, deadlines, case status, and Portal access.

The position is remote but requires residence within 50 miles of McAllen, TX; work is contingent on contract award.