Remote Eligibility Verifier – FEHB/PSHB

Maximus; Carson City (NV); Remote; USD 20,000 - 28,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB and PSHB benefits for enrollees, focusing on dependent eligibility verification and portal assistance.

The role handles inbound calls, provides guidance on documentation and deadlines, authenticates callers, protects PII/PHI, and documents each interaction in the FEHB Portal. Remote within 50 miles of McAllen, TX; contract contingent on award.

Qualifications

• High School diploma or equivalent and 6 months of customer service experience.
• Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including background investigations, fingerprinting, credentialing, and security training requirements.
• U.S. citizen required.

Responsibilities

• Provides customer service for basic and routine inquiries and problems via multiple channels (phone, email, web chat, or letters).
• Handles routine calls; may deviate from scripts when necessary; uses systems to track information and troubleshoot.
• Provides feedback on call trends, processes, and training; refers callers to published materials or senior staff when appropriate.
• Assists enrollees with Portal access, login issues, and document upload using approved scripts and resources.
• Authenticates callers before sharing case information and protects PII/PHI per privacy and security requirements.
• Documents each interaction accurately in the OPM FEHB Protection Act Portal or approved system of record.
• Escalates complex questions, language/accessibility needs, or potential fraud indicators per procedures.
• Meets attendance, schedule adherence, call quality, and documentation accuracy standards.

Education

High School diploma or equivalent

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB and PSHB benefits for enrollees, focusing on dependent eligibility verification and portal assistance.

The role handles inbound calls, provides guidance on documentation and deadlines, authenticates callers, protects PII/PHI, and documents each interaction in the FEHB Portal. Remote within 50 miles of McAllen, TX; contract contingent on award.