Remote FEHB Eligibility Verification Specialist

Maximus; Jackson (MS); Remote; USD 19,000 - 26,000; Full time

Job summary

Maximus seeks an Eligibility Verification Specialist to support FEHB/PSHB enrollment verification for OPM. The CSR II handles inbound calls, assists with portal access, and ensures accurate documentation while protecting PII/PHI.

The role requires a high school diploma with 6 months of customer service, and is remote within 50 miles of Lawrence, KS. Compliance, background checks, and security training are prerequisites.

Qualifications

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

Responsibilities

• Provide customer service for basic inquiries via 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, 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.
• Ensures 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

Education

High School diploma or equivalent

Job description

Maximus seeks an Eligibility Verification Specialist to support FEHB/PSHB enrollment verification for OPM. The CSR II handles inbound calls, assists with portal access, and ensures accurate documentation while protecting PII/PHI.

The role requires a high school diploma with 6 months of customer service, and is remote within 50 miles of Lawrence, KS. Compliance, background checks, and security training are prerequisites.