Remote Eligibility Verifier – Admin II Operations

Maximus; Santa Fe (NM); Remote; USD 19,000 - 26,000; Full time

Benefits offered by this job

Remote work within 75 miles of Lawrenc

Contract contingent on award

Equipment provided

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB program compliance. This full-time, remote role requires residency within 75 miles of Lawrence, KS, and entails detailed review of enrollee-submitted documentation for FEHB eligibility.

Responsibilities include document verification, handling routine calls, and maintaining confidential records, with strict adherence to privacy and security protocols. Government background check and security training are required.

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.

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

Communication

Record review

Time management

Education

High School diploma or equivalent

Tools

Electronic case records

Document imaging

Data entry systems

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB program compliance. This full-time, remote role requires residency within 75 miles of Lawrence, KS, and entails detailed review of enrollee-submitted documentation for FEHB eligibility.

Responsibilities include document verification, handling routine calls, and maintaining confidential records, with strict adherence to privacy and security protocols. Government background check and security training are required.