Senior Administrator – Appeals

This is a fully remote position, open to applicants in California.

📋 Description

• Stay informed about project and corporate policies and procedures.

• Serve as a Subject Matter Expert in one or more specific process areas.

• Evaluate data submitted for Independent Medical Review.

• Gather and assess incoming data and reports from treatment providers, facilities, participants, labs, and health plans.

• Enter essential information into the system.

• Address incoming inquiries from clients, health plans, providers, and enrollees concerning case status, program inquiries, and the appeals process.

• Adhere to established guidelines and instructions while proactively achieving objectives and meeting deadlines.

⛳️ Requirements

• Associate degree with over 2 years of relevant experience.

• Alternatively, a High School Diploma or GED with 4 or more years of experience can be considered.

• Minimum of 2 years of experience in healthcare, medical office administration, or a related sector.

• Competent in computer operations, including daily use of web-based applications.

• Strong analytical capabilities.

• Detail-oriented and solution-focused.

• Exceptional written and verbal communication skills.

• Familiarity with medical terminology.

• Proven experience in reviewing and processing medical records or other healthcare documentation with a high level of accuracy and attention to detail.

• Ability to work independently.

• Access to a private and secure workspace.

• Reliable high-speed internet connection: minimum 20 Mbps download/50 Mbps for shared internet access and 5 Mbps upload.

🏝️ Benefits

• Flexible work schedule.

• Comprehensive medical, dental, vision, and life insurance coverage.

• Discounts available for auto, home, renter's, and pet insurance.

• 401K retirement savings plan with company matching contributions.

• Paid time off including holidays and extended sick leave.

• Short- and long-term disability coverage.

• Employee Assistance Program promoting physical, emotional, and financial wellness.

• Recognition platform for employee achievements.

• Initiatives focused on diversity, equity, and inclusion.

• Tuition reimbursement for further education.

• Employee perks and discounts.

• Access to the Maximus Wellness Program and related resources.

• Opportunities for professional development through training programs, workshops, and conferences.

• Company-provided computer equipment.

• Comprehensive training offered.