Senior Medical Appeals Administrator (Remote)

Maximus; Northern (KY); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Work/Life balance

Health insurance

Retirement plan

PTO & disability

EAP

Tuition reimbursement

Wellness program

Employee discounts

Professional development

Job summary

Maximus invites applicants for a Senior Administrator - Appeals on the CA IMR team to support workers' compensation appeal case processing. The role focuses on analyzing and entering medical data, reviewing documentation for accuracy, and supporting the independent medical review workflow in a fast-paced setting.

This remote position offers flexible scheduling, comprehensive training, company-provided equipment, and a collaborative environment dedicated to helping employees succeed.

Qualifications

• Analyze data submitted for Independent Medical Review.
• Input necessary information into the system from treatment providers, facilities, and health plans.
• Respond to calls from clients, health plans, providers, and enrollees about case status and the appeals process.
• Follow guidelines and deadlines with a proactive approach.

Responsibilities

• Maintain updated knowledge of project and corporate policies.
• Serve as SME in one or more process areas.
• Analyze data for IMR accuracy and completeness.

Skills

Analytical skills

Detail-oriented

Medical terminology

Medical records review

Healthcare experience

Education

Associate degree

Job description

Maximus invites applicants for a Senior Administrator - Appeals on the CA IMR team to support workers' compensation appeal case processing. The role focuses on analyzing and entering medical data, reviewing documentation for accuracy, and supporting the independent medical review workflow in a fast-paced setting.

This remote position offers flexible scheduling, comprehensive training, company-provided equipment, and a collaborative environment dedicated to helping employees succeed.