Remote FEHB Eligibility Verification Specialist

Maximus; Boise (ID); Remote; USD 20,000 - 28,000; Full time

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB enrollment verifications and provide inbound telephone support for dependent eligibility verification. The CSR II assists enrollees with Portal access, document submission, and navigation of program resources, ensuring privacy and data protection per requirements.

Remote role with location constraint within 50 miles of McAllen, TX; contingent upon contract award.

Qualifications

• High School diploma or equivalent with 6 months of customer service experience.
• May have additional training or education in area of specialization.
• Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including 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 (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 and input on call trends, processes, procedures, and training.
• Assists enrollees with Portal access, login issues, and document upload using 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 procedures.
• Meets attendance, schedule adherence, call quality, and documentation accuracy standards.

Skills

Customer service

Phone support

Documentation

Portal access

Education

High School diploma

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB enrollment verifications and provide inbound telephone support for dependent eligibility verification. The CSR II assists enrollees with Portal access, document submission, and navigation of program resources, ensuring privacy and data protection per requirements.

Remote role with location constraint within 50 miles of McAllen, TX; contingent upon contract award.