Remote Inbound Eligibility Specialist

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

Job summary

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB programs for enrollees, handling dependent eligibility verification and portal navigation. The CSR II serves as frontline support with inbound calls and documentation processing.

Remote position within 50 miles of Lawrence, KS; requires U.S. citizenship and the ability to obtain a Moderate Risk Public Trust suitability determination. Equal opportunity employer.

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.
• Must be a U.S. Citizen.

Responsibilities

• Provides customer service for basic and routine inquiries via telephone, email, web chats, or letters.
• Uses computerized systems for tracking, information gathering, and troubleshooting.
• Provides inbound telephone support to enrollees on eligibility verification requirements and case status.
• Assists callers with Portal access, login issues, and document upload.
• Authenticates callers before sharing case information and protects PII/PHI.
• Documents interactions accurately in the FEHB Portal or approved system.
• Escalates complex questions and potential fraud indicators per procedures.
• Meets attendance, schedule adherence, call quality, and documentation standards.

Skills

Customer service

Education

High School diploma or equivalent

Job description

Maximus is seeking an Eligibility Verification Specialist to support FEHB/PSHB programs for enrollees, handling dependent eligibility verification and portal navigation. The CSR II serves as frontline support with inbound calls and documentation processing.

Remote position within 50 miles of Lawrence, KS; requires U.S. citizenship and the ability to obtain a Moderate Risk Public Trust suitability determination. Equal opportunity employer.