Remote Eligibility Verification Specialist - FEHB/PSHB

Maximus; Hagåtña (GU); Remote; USD 20,000 - 28,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB program enrollees, handling inbound calls on dependent eligibility verification, documentation, and portal access. This CSR II role focuses on accurate information, privacy, and timely responses from a central Portal.

Responsibilities include guiding enrollees through documentation requirements, answering questions about deadlines and case status, and escalating complex issues per procedures.

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 channels.
• 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, 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.

Skills

Customer service

Telephone support

Education

High School diploma or equivalent

6 months of customer service experience

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB program enrollees, handling inbound calls on dependent eligibility verification, documentation, and portal access. This CSR II role focuses on accurate information, privacy, and timely responses from a central Portal.

Responsibilities include guiding enrollees through documentation requirements, answering questions about deadlines and case status, and escalating complex issues per procedures.